Skip to main content
Erschienen in: Supportive Care in Cancer 8/2012

01.08.2012 | Original Article

Nutritional status, acute phase response and depression in metastatic lung cancer patients: correlations and association prognosis

verfasst von: Zoe Giannousi, Ioannis Gioulbasanis, Athanasios G. Pallis, Alexandros Xyrafas, Danai Dalliani, Kostas Kalbakis, Vassilis Papadopoulos, Dimitris Mavroudis, Vassilis Georgoulias, Christos N. Papandreou

Erschienen in: Supportive Care in Cancer | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Background and aim

Cancer cachexia is a metabolic syndrome related with poor outcome. Cytokines play a key role in the pathophysiology of that syndrome. The aim of this study was to investigate the potential correlations between nutritional status, systemic inflammation, and psychological distress in cancer patients. The prognostic significance of the recorded parameters was also assessed.

Patients and methods

Patients with metastatic lung cancer were eligible. Mini Nutritional Assessment (MNA) was used for the evaluation of nutritional status, Glasgow Prognostic Score (GPS) for the estimation of systemic inflammation, and Hospital Anxiety and Depression Scale (HADS) for psychological assessment.

Results

Totally, 122 patients were enrolled (71.3% with NSCLC and 28.7% with SCLC). The following correlations were observed: MNA and GPS (r = 0.289, p = 0.001), MNA and HADS (depression scale) (r = 0.275, p = 0.002), GPS and HADS (depression scale) (r = 0.256, p = 0.004), and GPS and HADS (anxiety scale) (r = 0.194, p = 0.033). In univariate analysis, GPS (p = 0.002) and MNA (p = 0.010) emerged as significant predictors of survival. In multivariate analysis, both MNA (p = 0.032) and GPS (p = 0.020) retained their importance.

Conclusions

This study highlights the associations between nutritional status, systemic inflammation, and psychological distress, supporting their common underlying pathophysiological mechanisms and further suggesting the necessity of a holistic anti-cachectic approach.
Literatur
1.
Zurück zum Zitat Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69:491–497PubMedCrossRef Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR et al (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med 69:491–497PubMedCrossRef
2.
Zurück zum Zitat Murry DJ, Riva L, Poplack DG (1998) Impact of nutrition on pharmacokinetics of anti-neoplastic agents. Int J Cancer Suppl 11:48–51PubMedCrossRef Murry DJ, Riva L, Poplack DG (1998) Impact of nutrition on pharmacokinetics of anti-neoplastic agents. Int J Cancer Suppl 11:48–51PubMedCrossRef
3.
Zurück zum Zitat Hammerlid E, Wirblad B, Sandin C, Mercke C, Edstrom S, Kaasa S et al (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck 20:540–548PubMedCrossRef Hammerlid E, Wirblad B, Sandin C, Mercke C, Edstrom S, Kaasa S et al (1998) Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck 20:540–548PubMedCrossRef
4.
Zurück zum Zitat Evans WJ, Morley JE, Argiles J, Bales C, Baracos V, Guttridge D et al (2008) Cachexia: a new definition. Clin Nutr 27:793–799PubMedCrossRef Evans WJ, Morley JE, Argiles J, Bales C, Baracos V, Guttridge D et al (2008) Cachexia: a new definition. Clin Nutr 27:793–799PubMedCrossRef
5.
Zurück zum Zitat Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495PubMedCrossRef Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495PubMedCrossRef
6.
Zurück zum Zitat Houten L, Reilley AA (1980) An investigation of the cause of death from cancer. J Surg Oncol 13:111–116PubMedCrossRef Houten L, Reilley AA (1980) An investigation of the cause of death from cancer. J Surg Oncol 13:111–116PubMedCrossRef
7.
Zurück zum Zitat Muscaritoli M, Bossola M, Aversa Z, Bellantone R, Rossi FF (2006) Prevention and treatment of cancer cachexia: new insights into an old problem. Eur J Cancer 42:31–41PubMedCrossRef Muscaritoli M, Bossola M, Aversa Z, Bellantone R, Rossi FF (2006) Prevention and treatment of cancer cachexia: new insights into an old problem. Eur J Cancer 42:31–41PubMedCrossRef
8.
Zurück zum Zitat MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE (2003) Understanding and managing cancer cachexia. J Am Coll Surg 197:143–161PubMedCrossRef MacDonald N, Easson AM, Mazurak VC, Dunn GP, Baracos VE (2003) Understanding and managing cancer cachexia. J Am Coll Surg 197:143–161PubMedCrossRef
9.
Zurück zum Zitat Gioulbasanis I, Baracos VE, Giannousi Z, Xyrafas A, Martin L, Georgoulias V et al (2011) Baseline nutritional evaluation in metastatic lung cancer patients: Mini Nutritional Assessment versus weight loss history. Ann Oncol 22:835–841PubMedCrossRef Gioulbasanis I, Baracos VE, Giannousi Z, Xyrafas A, Martin L, Georgoulias V et al (2011) Baseline nutritional evaluation in metastatic lung cancer patients: Mini Nutritional Assessment versus weight loss history. Ann Oncol 22:835–841PubMedCrossRef
10.
Zurück zum Zitat Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ (2004) Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 90:1704–1706PubMed Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ (2004) Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer 90:1704–1706PubMed
11.
Zurück zum Zitat Hopwood P, Stephens RJ (2000) Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol 18:893–903PubMed Hopwood P, Stephens RJ (2000) Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol 18:893–903PubMed
13.
Zurück zum Zitat Illman J, Corringham R, Robinson D Jr, Davis HM, Rossi JF, Cella D et al (2005) Are inflammatory cytokines the common link between cancer-associated cachexia and depression? J Support Oncol 3:37–50PubMed Illman J, Corringham R, Robinson D Jr, Davis HM, Rossi JF, Cella D et al (2005) Are inflammatory cytokines the common link between cancer-associated cachexia and depression? J Support Oncol 3:37–50PubMed
14.
Zurück zum Zitat Pallis AG, Wedding U, Lacombe D, Soubeyran P, Wildiers H (2010) Questionnaires and instruments for a multidimensional assessment of the older cancer patient: what clinicians need to know? Eur J Cancer 46:1019–1025PubMedCrossRef Pallis AG, Wedding U, Lacombe D, Soubeyran P, Wildiers H (2010) Questionnaires and instruments for a multidimensional assessment of the older cancer patient: what clinicians need to know? Eur J Cancer 46:1019–1025PubMedCrossRef
15.
Zurück zum Zitat Padilla GV (1986) Psychological aspects of nutrition and cancer. Surg Clin North Am 66:1121–1135PubMed Padilla GV (1986) Psychological aspects of nutrition and cancer. Surg Clin North Am 66:1121–1135PubMed
16.
Zurück zum Zitat Lesko LM (1989) Psychosocial issues in the diagnosis and management of cancer cachexia and anorexia. Nutrition 5:114–116PubMed Lesko LM (1989) Psychosocial issues in the diagnosis and management of cancer cachexia and anorexia. Nutrition 5:114–116PubMed
17.
Zurück zum Zitat Bruera E (1997) ABC of palliative care. Anorexia, cachexia, and nutrition. BMJ 315:1219–1222PubMedCrossRef Bruera E (1997) ABC of palliative care. Anorexia, cachexia, and nutrition. BMJ 315:1219–1222PubMedCrossRef
19.
Zurück zum Zitat Seruga B, Zhang H, Bernstein LJ, Tannock IF (2008) Cytokines and their relationship to the symptoms and outcome of cancer. Nat Rev Cancer 8:887–899PubMedCrossRef Seruga B, Zhang H, Bernstein LJ, Tannock IF (2008) Cytokines and their relationship to the symptoms and outcome of cancer. Nat Rev Cancer 8:887–899PubMedCrossRef
20.
Zurück zum Zitat Musselman DL, Miller AH, Porter MR, Manatunga A, Gao F, Penna S et al (2001) Higher than normal plasma interleukin-6 concentrations in cancer patients with depression: preliminary findings. Am J Psychiatry 158:1252–1257PubMedCrossRef Musselman DL, Miller AH, Porter MR, Manatunga A, Gao F, Penna S et al (2001) Higher than normal plasma interleukin-6 concentrations in cancer patients with depression: preliminary findings. Am J Psychiatry 158:1252–1257PubMedCrossRef
21.
Zurück zum Zitat Kraus MR, Schafer A, Al-Taie O, Scheurlen M (2005) Prophylactic SSRI during interferon alpha re-therapy in patients with chronic hepatitis C and a history of interferon-induced depression. J Viral Hepat 12:96–100PubMedCrossRef Kraus MR, Schafer A, Al-Taie O, Scheurlen M (2005) Prophylactic SSRI during interferon alpha re-therapy in patients with chronic hepatitis C and a history of interferon-induced depression. J Viral Hepat 12:96–100PubMedCrossRef
22.
Zurück zum Zitat Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R et al (2007) The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2:706–714PubMedCrossRef Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R et al (2007) The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2:706–714PubMedCrossRef
24.
Zurück zum Zitat Huhmann MB, Cunningham RS (2005) Importance of nutritional screening in treatment of cancer-related weight loss. Lancet Oncol 6:334–343PubMedCrossRef Huhmann MB, Cunningham RS (2005) Importance of nutritional screening in treatment of cancer-related weight loss. Lancet Oncol 6:334–343PubMedCrossRef
25.
Zurück zum Zitat McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12:223–226PubMedCrossRef McMillan DC (2009) Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 12:223–226PubMedCrossRef
26.
Zurück zum Zitat McMillan DC (2008) An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer. Proc Nutr Soc 67:257–262PubMedCrossRef McMillan DC (2008) An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer. Proc Nutr Soc 67:257–262PubMedCrossRef
27.
Zurück zum Zitat Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef
28.
Zurück zum Zitat Vodermaier A, Linden W, Siu C (2009) Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Natl Cancer Inst 101:1464–1488PubMedCrossRef Vodermaier A, Linden W, Siu C (2009) Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Natl Cancer Inst 101:1464–1488PubMedCrossRef
29.
Zurück zum Zitat Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L (2004) The Hospital Anxiety and Depression Scale in Greek cancer patients: psychometric analyses and applicability. Support Care Cancer 12:821–825PubMedCrossRef Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L (2004) The Hospital Anxiety and Depression Scale in Greek cancer patients: psychometric analyses and applicability. Support Care Cancer 12:821–825PubMedCrossRef
30.
Zurück zum Zitat Collet D (1994) Modelling survival data in medical research, 3rd edn. Blackwell Scientific, Oxford Collet D (1994) Modelling survival data in medical research, 3rd edn. Blackwell Scientific, Oxford
31.
Zurück zum Zitat Walsh D, Doona M, Molnar M, Lipnickey V (2000) Symptom control in advanced cancer: important drugs and routes of administration. Semin Oncol 27:69–83PubMed Walsh D, Doona M, Molnar M, Lipnickey V (2000) Symptom control in advanced cancer: important drugs and routes of administration. Semin Oncol 27:69–83PubMed
32.
Zurück zum Zitat Stone P, Richardson A, Ream E, Smith AG, Kerr DJ, Kearney N (2000) Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum. Ann Oncol 11:971–975PubMedCrossRef Stone P, Richardson A, Ream E, Smith AG, Kerr DJ, Kearney N (2000) Cancer-related fatigue: inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Cancer Fatigue Forum. Ann Oncol 11:971–975PubMedCrossRef
33.
Zurück zum Zitat Chang VT, Hwang SS, Feuerman M, Kasimis BS (2000) Symptom and quality of life survey of medical oncology patients at a veterans affairs medical center: a role for symptom assessment. Cancer 88:1175–1183PubMedCrossRef Chang VT, Hwang SS, Feuerman M, Kasimis BS (2000) Symptom and quality of life survey of medical oncology patients at a veterans affairs medical center: a role for symptom assessment. Cancer 88:1175–1183PubMedCrossRef
34.
Zurück zum Zitat Nitenberg G, Raynard B (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 34:137–168PubMedCrossRef Nitenberg G, Raynard B (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol 34:137–168PubMedCrossRef
35.
Zurück zum Zitat Tewari N, Martin-Ucar AE, Black E, Beggs L, Beggs FD, Duffy JP et al (2007) Nutritional status affects long term survival after lobectomy for lung cancer. Lung Cancer 57:389–394PubMedCrossRef Tewari N, Martin-Ucar AE, Black E, Beggs L, Beggs FD, Duffy JP et al (2007) Nutritional status affects long term survival after lobectomy for lung cancer. Lung Cancer 57:389–394PubMedCrossRef
36.
Zurück zum Zitat Bauer JD, Capra S (2005) Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy–a pilot study. Support Care Cancer 13:270–274PubMedCrossRef Bauer JD, Capra S (2005) Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy–a pilot study. Support Care Cancer 13:270–274PubMedCrossRef
37.
Zurück zum Zitat Proctor MJ, Morrison DS, Talwar D, Balmer SM, O'Reilly DS, Foulis AK et al (2011) An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome Study. Br J Cancer 104:726–734PubMedCrossRef Proctor MJ, Morrison DS, Talwar D, Balmer SM, O'Reilly DS, Foulis AK et al (2011) An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome Study. Br J Cancer 104:726–734PubMedCrossRef
38.
Zurück zum Zitat Blum D, Omlin A, Fearon K, Baracos V, Radbruch L, Kaasa S et al (2010) Evolving classification systems for cancer cachexia: ready for clinical practice? Support Care Cancer 18:273–279PubMedCrossRef Blum D, Omlin A, Fearon K, Baracos V, Radbruch L, Kaasa S et al (2010) Evolving classification systems for cancer cachexia: ready for clinical practice? Support Care Cancer 18:273–279PubMedCrossRef
39.
Zurück zum Zitat Fox KM, Brooks JM, Gandra SR, Markus R, Chiou CF (2009) Estimation of cachexia among cancer patients based on four definitions. J Oncol 2009:693458PubMedCrossRef Fox KM, Brooks JM, Gandra SR, Markus R, Chiou CF (2009) Estimation of cachexia among cancer patients based on four definitions. J Oncol 2009:693458PubMedCrossRef
40.
Zurück zum Zitat Chasen MR, Dippenaar AP (2008) Cancer nutrition and rehabilitation-its time has come! Curr Oncol 15:117–122PubMed Chasen MR, Dippenaar AP (2008) Cancer nutrition and rehabilitation-its time has come! Curr Oncol 15:117–122PubMed
41.
Zurück zum Zitat Laugsand EA, Sprangers MA, Bjordal K, Skorpen F, Kaasa S, Klepstad P (2010) Health care providers underestimate symptom intensities of cancer patients: a multicenter European study. Health Qual Life Outcome 8:104CrossRef Laugsand EA, Sprangers MA, Bjordal K, Skorpen F, Kaasa S, Klepstad P (2010) Health care providers underestimate symptom intensities of cancer patients: a multicenter European study. Health Qual Life Outcome 8:104CrossRef
Metadaten
Titel
Nutritional status, acute phase response and depression in metastatic lung cancer patients: correlations and association prognosis
verfasst von
Zoe Giannousi
Ioannis Gioulbasanis
Athanasios G. Pallis
Alexandros Xyrafas
Danai Dalliani
Kostas Kalbakis
Vassilis Papadopoulos
Dimitris Mavroudis
Vassilis Georgoulias
Christos N. Papandreou
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 8/2012
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-011-1282-x

Weitere Artikel der Ausgabe 8/2012

Supportive Care in Cancer 8/2012 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.