Correlation of the Karnofsky performance status (KPS) with nutritional status as measured by the Scored Patient-generated Subjective Global Assessment (PG-SGA) in patients with advanced cancer in palliative treatment

Abstract

20709 Background: The incidence of malnutrition amongst patients with cancer is estimated at between 40 and 80%. Prompt detection of nutritional compromise is critical to initiate early nutritional and/or pharmacological interventions with the aim to improve the quality- of-life of cancer patients. The PG-SGA is a simple, reliable and inexpensive screening tool that uses clinical data to detect mild or moderate malnutrition before the patient becomes overly wasted. Our main objective was to characterize the nutritional status of patients with advanced cancer receiving palliative care, as measured by the PG-SGA and correlate its results with the KPS of this patient cohort. Methods: We evaluated the PG-SGA and the KPS of 74 patients with advanced stage cancer in palliative treatment. Results: Patients were aged 24–81 years (median 57 years). Forty-two patients were women (55%), and 30 of the patients (40%) were hospitalized. The most common neoplasms were: lung 39%, colorectal 18% and breast 10%. The main symptoms negatively affecting oral intake were: anorexia 70%, early satiety 62%, pain 57%, xerostomia 53%, altered smell and taste 40%, constipation 33%, dysphagia 31% and nausea 28%. According to the PG-SGA, 48% (36) were moderately or suspected of being malnourished, 30 (22%) of patients were severely malnourished and 22% (13) of patients were well-nourished. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P<0.001), with the severely malnourished patients having the highest scores. The functional capacity, as evaluated by the KPS, demonstrated that 36 (49%) scored between 50–70%, 26 (35%) between 10–40% and 12 patients (16%) between 80–100%. The median KPS was 50%. There was a statistically significant correlation between the scored PG-SGA and the KPS (r = −0.63, p<0.001). Conclusions: The ASG-PPP score and the KPS are highly correlated in patients with advanced cancer, supporting the concept that the KPS is an important and informative variable in the evaluation of the nutritional status in these patients. The nature of this correlation and its clinical implications need to be further investigated. No significant financial relationships to disclose.