Nutritional status and related factors of patients with advanced lung cancer in northern China: a retrospective study

Abstract

Background: Mortality of lung cancer in northern China has been increasing at an alarming speed. The consequences of malnutrition may include an increased risk of many complications. However, the nutritional status in advanced lung cancer patients is still unknown. So the aims of this research are to report on the prevalence of malnutrition in our population, the proportion of participants requiring nutrition interventions, and the relationship between nutritional status at diagnosis and overall survival (OS).

Patients and methods: We evaluated 495 patients with advanced lung cancer (stage IIIB and IV). Nutritional status was estimated by the Patient-Generated Subjective Global Assessment (PG-SGA). This study investigated the clinical significance of PG-SGA scores at admission by following OS. Kaplan-Meier survival analysis and the log-rank test were used to calculate OS. Univariate and multivariate analyses of the OS were performed using Cox analysis.

Results: Our results showed that 88.9% of the patients required nutrition intervention and 25.1% of the patients required improved nutrition-related symptom management and/or urgent nutritional support (PG-SGA score ≥9). Factors related to malnutrition were age, sex, pathology, TNM stage, smoking condition, anemia, body mass index, pre-albumin, and albumin. The research outcomes indicated that PG-SGA score at admission was significantly associated with OS, which was still maintained when stratified by age and sex.

Conclusion: Malnutrition was prevalent in patients with advanced lung cancer. Poor nutritional status was associated with worse clinical outcomes.

Keywords: PG-SGA; lung cancer; malnutrition; nutritional assessment; survival.

Figure 1

Kaplan–Meier survival curves by PG-SGA scores in patients with advanced lung cancer. Notes: Log-rank between-group comparison P<0.001. Cox analysis showed that the Cox risk ratio was 2.128 (95% CI: 1.855–2.440). Abbreviation: PG-SGA, Patient-Generated Subjective Global Assessment.

Figure 2

Overall survival based on PG-SGA scores in patients aged ≥60 years (A), <60 years (B), male patients (C), and female patients (D), respectively. Abbreviation: PG-SGA, Patient-Generated Subjective Global Assessment.