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The Korean Journal of Medicine 2006;71(2): 132-140.
진행성 소화기계 종양 환자에서 영양상태와 예후와의 관계
최 권, Hae Jeung Kim, Hyun Jin Cho, Young Ghil Choe, Do Young Lee, Sung Keun Park, Young Lyul Koh, Suk Joong Oh, Seung Sei Lee
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Assessment of nutritional status and prognosis in advanced metastatic cancer
Kwon Choi, Hae Jeung Kim, Hyun Jin Cho, Young Ghil Choe, Do Young Lee, Sung Keun Park, Young Lyul Koh, Suk Joong Oh, Seung Sei Lee
Seoul National University College of Medicine
ABSTRACT
Background : Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The PINI (prognostic inflammatory nutritional index) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill patients. The aim of this study was designed to investigate the relationship between nutritional status after the palliative chemotherapy and prognosis in advanced metastatic cancer. Methods : This study included 130 patients with ECOG PS (Eastern Cooperative Oncology Group performance status) 1~3 in advanced metastatic cancer following the palliative chemotherapy. ECOG PS, body mass index, alpha 1-acid glycoprotein, C-reactive protein, albumin, prealbumin, transferrin, protein, lactate dehydrogenase, PINI ratio, and survival time were evaluated. Results : In 130 patients, the median age was 57 years. The ECOG PS was 1 68 patients, 2 43, 3 19. The mean value of PINI was PS 1 16.0±47.8, PS 2 55.6±106.9, PS 3 106.3±141.6. The mean survival was PS 1 144.0±71.8, PS 2 68.9±41.2, PS 3 32.0±6.9 days. In the PS 3 group, the mean values of alpha 1-acid glycoprotein, C-reactive protein, and lactate dehydrogenase were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of albumin, prealbumin, and transferrin were significantly lower than in the PS 1 group. The survival time was correlated with the ECOG PS (r=-0.602, p<0.001,), PINI (r=-0.318, p<0.001,), alpha 1-acid glycoprotein (r=-0.265, p=0.002), C-reactive protein (r=-0.345, p<0.001), albumin (r=0.324, p<0.001), prealbumin (r=0.260, p=0.003) and transferrin (r=0.277, p=0.001). Conclusions : The PINI may be a useful scoring system for the assessment of nutritional status and prognosis in advanced metastatic cancer following palliative chemotherapy, but the ECOG PS is most strong correlation with the survival time. Key Words : Nutrition assessment, Prognosis, Cancer
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