Nutritional assessment and patient outcome during oncological therapy

• Published in: Cancer 1979-05, Vol.43 (S5), p.2065-2069
• Main Authors: Harvey, Karen B., Bothe, Albert, Blackburn, George L.
• Format: Article
• Language: English
• Subjects: Body Constitution; Female; Humans; Immunity; Neoplasms - complications; Neoplasms - immunology; Neoplasms - therapy; Nutrition Disorders - diagnosis; Nutrition Disorders - etiology; Nutrition Disorders - immunology; Serum Albumin - analysis; Transferrin - analysis
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(197905)43:5+<2065::AID-CNCR2820430714>3.0.CO;2-1

Protein‐calorie malnutrition is the single most common secondary diagnosis in patients with cancer, and is a direct consequence of the anorexia of malignancy and altered host metabolism induced by tumor. One hundred and sixty‐one cancer patients were nutritionally assessed prior to receiving oncological therapy (surgery, chemotherapy, and/or radiation therapy). Eighty‐four percent (27/32) of the patients who were initially anergic became immunocompetent with nutritional therapy and had a mortality rate of 11% as compared to 100% mortality in the 5 patients who remained anergic throughout their hospital stay. Thirty‐nine percent (14/36) of the patients initially immune competent became anergic and had a concomitant mortality rate of 50% vs. a mortality rate of only 14% in the 22 patients whose immune function was preserved (p < 0.05). Those patients who were discharged at the completion of their therapy also exhibited a higher initial serum albumin (3.5 ± 0.1 vs. 3.1 ± 0.1 g/dl, p < 0.001) and serum transferrin (149 ± 7 vs. 125 ± 7 mg/dl, p < 0.05). A significant increase (p < 0.025) occurred in serum transferrin (Δ23 ± 9 mg/dl) after 3 or more weeks of nutritional support. The detection and treatment of protein‐calorie malnutrition prior to or in conjunction with oncological therapy has been associated with a decrease in mortality rate.