Abstract
BackgroundMalnutrition is often observed in gynecological cancer patients, however its prevalence in these patients remains largely unexplored. Total parenteral nutrition (TPN) is a nutritional intervention method that has controversial treatment outcome on gynecological cancer patients. The present retrospective study is designed to evaluate the nutrition status and TPN treatment outcome on patients diagnosed with endometrial, cervical or ovarian malignant tumors.MethodsMedical records of a total of 263 patients treated at the First Hospital of Shanxi Medical University, China were included. Nutrition status was assessed by patient-generated subjective global assessment (PG-SGA). Patients were grouped based on nutrition status, cancer type or treatment strategy for clinical characteristic comparison. Multivariable logistic regression analysis was used to identify predictors for malnutrition status and hospital stay duration.ResultsPresence of endometrial and cervical cancer, body weight before nutritional intervention and serum albumin level (P < 0.001 for all) were found to be significant predictors for malnutrition status in gynecological cancer patients. In the malnourished patients, those who were treated with TPN had significantly lower serum albumin levels before and after treatment (P < 0.001) and PG-SGA scores after treatment. Also, TPN treatment could significantly increase the serum albumin levels in these patients after 1 week. In addition, shorter hospitalization period was needed for TPN-treated endometrial (P = 0.019) and ovarian (P < 0.001) patients. Moreover, serum albumin levels (P < 0.001), use of TPN treatment (P = 0.025) and nutrition status (P = 0.010) were identified to be independent predictors for hospital stay duration.ConclusionOur results suggest that malnutrition is a significant clinical manifestation in gynecological cancer patients who may benefit from TPN treatment for reduced hospitalization and improved serum albumin levels.
Highlights
Malnutrition is a common situation observed in many hospitalized patients, especially in those who suffered from geriatric and malignant diseases [1]
We found that serum albumin levels both before and 1 week after the nutritional treatment were significantly lower in patients who needed Total parenteral nutrition (TPN) treatment (Table 4), which was able to significantly increase the serum albumin level 1 week after treatment (P < 0.001)
Nutrition education has been shown to have a positive effect on reducing the incidence of malnutrition in ovarian [28], head and neck [29] and breast cancer [30]. In light with these data, adding these methods on top of TPN treatment might be useful for gynecological cancer patients. In line with another previous study [31] and our recent findings [32], we found that serum albumin levels both before and after the nutritional intervention were significantly lower in the TPN treated patients
Summary
Malnutrition is a common situation observed in many hospitalized patients, especially in those who suffered from geriatric and malignant diseases [1]. Previous study shows that patients with ovarian cancer were more susceptible to malnutrition at initial diagnosis (66.7%) compared with endometrial and cervical cancer [13]. Another study shows that 76.1% of the patients undergoing postoperative chemotherapy for ovarian cancer were moderately or severely malnourished [14]. Malnutrition in cancer patients is a result of poor nutrient intake combined with excessive metabolic demand of the malignant tissue. This abnormally high demand was caused by an elevated production of pro-inflammatory cytokines that stimulates proteolysis and leads to loss of lean tissue mass [15]. The present retrospective study is designed to evaluate the nutrition status and TPN treatment outcome on patients diagnosed with endometrial, cervical or ovarian malignant tumors
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