Evaluation of mini nutritional assessment (MNA) in metastatic lung cancer patients: Correlation of laboratory values indicating malnutrition, inflammation, and cachexia with clinical data

Abstract

19062 Background: Lung cancer is frequently associated with significant morbidity and malnutrition. Early recognition of cachexia is problematic because specific symptoms and reliable objective measurements are lacking. Screening questionnaires like the Mini Nutritional Assessment (MNA) (www.mna-elderly.com) may allow early identification of cachectic patients. Methods: From 4/2006 to 11/2007 all patients with metastatic lung cancer were evaluated using the MNA. Patients were divided into 3 groups according to MNA-score (A: adequate nutrition; B: risk of malnutrition; C: malnutrition). The primary end point was the evaluation of the relation between the MNA and laboratory measurements indicative of malnutrition, inflammation and cachexia before the onset of chemotherapy. Results: 163 patients (147 males) with median age 65.4 years were evaluated. The percentages and the observed values (mean ± SD) of the studied parameters for each group as well as comparisons between groups A+B vs C and A vs B+C are tabulated in the table below. After a median follow up of 9.5 months (range, 0.03–22.9), MNA score was significantly correlated with overall survival for group A vs BC (p=0.007) whereas there was a marked difference for groups AB vs C (p=0.081). Conclusion: The MNA is an easy and reliable questionnaire that can be used to identify early cachexia in lung cancer patients. Group [N (%)] A [46 (28.2%)] B [75 (46.0%)] C [42 (25.7%)] A+B vs C A vs B+C Age 63.0±8.5 66.9±10.6 63.4±10.2 ns 0.085 Performance status 0.6±0.7 1.4±0.9 1.9±1.2 *0.001 *<0.001 Body mass index 26.3±4.8 24.2±5.3 23.9±4.1 ns *0.032 No of metastatic sites 2.2±1.2 2.7±1.0 3.0±0.9 0.059 *0.010 Hemoglobin (gr/dl) 13±2.4 12.3±1.8 11.9±2.4 ns *0.013 Lymphocytes (/dl) 1400±699 1476±739 1451±518 ns ns Albumin (gr/dl) 4.2±0.4 3.5±0.5 3.4±0.5 *0.005 *<0.001 Cr Clearance 110±35.0 92.0±39.2 85.1±31.2 0.079 *0.016 CRP (mg/dl) 3.1±4.6 8.4±10.4 7.3±5.9 *0.027 *<0.001 Ferritine (mg/dl) 236±61 295±233 284±216 ns 0.084 IL-6 7.6±8.6 52±132 22.7±20.0 0.065 *0.001 TNFa 1073±1546 1206±1619 1237±2451 ns ns IL-8 20.7±35.2 81±210 257±694 0.050 *0.001 ns = non significant; * p<0.05 No significant financial relationships to disclose.