Evaluation of two nutritional scores' association with systemic treatment toxicity and survival in metastatic colorectal cancer: an AGEO prospective multicentre study.
Aged
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Colorectal Neoplasms
/ drug therapy
Drug-Related Side Effects and Adverse Reactions
/ complications
Female
Humans
Kaplan-Meier Estimate
Male
Malnutrition
/ complications
Middle Aged
Multivariate Analysis
Neoplasm Metastasis
Nutrition Assessment
Nutritional Status
Prospective Studies
Chemotherapy toxicity
Malnutrition
Metastatic colorectal cancer
NRI
PG-SGA
Prognosis
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
16
01
2019
revised:
24
06
2019
accepted:
02
07
2019
pubmed:
16
8
2019
medline:
9
6
2020
entrez:
16
8
2019
Statut:
ppublish
Résumé
The Patient-Generated Subjective Global Assessment (PG-SGA) is currently the standard nutritional assessment tool for patients with cancer. In a retrospective assessment of a prospective cohort, we showed that the Nutritional Risk Index (NRI) seemed to be associated with treatment toxicity and survival in patients with metastatic colorectal cancer (mCRC). The objective of this study was to compare these two nutritional tools (PG-SGA and NRI) on their correlation with chemotherapy-related toxicity and survival in non-pre-treated patients with mCRC. This prospective multicentre observational study enrolled non-pre-treated patients with mCRC. PG-SGA and NRI were performed at the onset of first-line chemotherapy. Treatment-related toxicities were registered according to National Cancer Institute Common Toxicity Criteria Adverse Event version 4.0. Progression-free survival (PFS) and overall survival (OS) were calculated from the start of treatment. A total of 168 patients were included from eight French centres. Patients were considered malnourished in 41% of cases according to PG-SGA and 56% of cases according to the NRI. In multivariate analysis, malnutrition according to PG-SGA was significantly associated with chemotherapy-related grade ≥2 clinical toxicities (odds ratio: 3.7; 95% confidence interval [CI]: 1.7-8.4; p = 0.001) and OS (hazard ratio [HR]: 2.6; 95% CI: 1.3-5.3; p = 0.006), but not with PFS (HR: 1.5; 95% CI: 0.8-2.6; p = 0.2). Conversely, malnutrition according to the NRI was not significantly associated with these tolerance and efficacy parameters. Although more complex to perform in daily oncology practice, the PG-SGA score appears to be the best nutritional assessment tool because of its strong association with clinically relevant oncological outcomes such as OS and treatment-related toxicities in patients with mCRC.
Identifiants
pubmed: 31415985
pii: S0959-8049(19)30411-3
doi: 10.1016/j.ejca.2019.07.011
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-43Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.