The relationship between quality of life and nutritional status in advanced colorectal cancer

Abstract

3697 Background: Recently, there has been an increasing awareness about the role of Quality of Life (QoL) in advanced cancer. As a result, QoL measurements are increasingly being incorporated into clinical oncology practice. Nutritional intervention has been hypothesized to have a positive impact on QoL in patients with advanced colorectal cancer, however, little is known about the relationship between nutritional status and QoL. The goal of this study was to investigate the association between baseline nutritional status and QoL in advanced colorectal cancer. Methods: We examined a case series of 30 histologically confirmed stages III-IV colorectal cancer patients treated at Cancer Treatment Centers of America® at Midwestern Regional Medical Center between March 2001 and January 2003. Nutritional status was evaluated using the Subjective Global Assessment (SGA), a validated nutritional assessment tool in clinical oncology. QoL was evaluated using the EORTC QLQ-C30 (EORTC) and the Ferrans and Powers Quality of Life Index (QLI). The mean scores for all QoL domains were compared across the two classes of nutritional status using Analysis of Variance. Results: Twenty-one (70%) patients were identified as well nourished and nine (30%) as moderately malnourished by the SGA. The mean scores in well-nourished patients were higher (suggesting better function) than those in malnourished patients for most QoL functional domains in both EORTC and QLI. The results achieved statistical significance (at p<=0.10) for role and social function (p=0.046 and 0.069 respectively) in EORTC and family function (p=0.023) in QLI. Similarly, the mean scores in malnourished patients were higher (suggesting worse symptoms) than those in well-nourished patients for most symptom scales in EORTC. The results achieved statistical significance for pain (0.079) and appetite loss (0.022). Conclusions: This study suggests that malnutrition in advanced colorectal cancer is associated with poor QoL for some functional and symptom domains. Future studies with larger sample sizes should focus on evaluating the impact of nutritional intervention on the QoL outcomes of these patients. No significant financial relationships to disclose.