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Observational Study
. 2021 Dec 10;21(1):687.
doi: 10.1186/s12877-021-02662-4.

PG-SGA SF in nutrition assessment and survival prediction for elderly patients with cancer

Qi Zhang #  1   2   3   4 , Xiang-Rui Li #  1   2   3 , Xi Zhang #  1   2   3 , Jia-Shan Ding  5 , Tong Liu  1 , Liang Qian  6 , Meng-Meng Song  1   2   3 , Chun-Hua Song  7 , Rocco Barazzoni  8 , Meng Tang  1   2   3 , Kun-Hua Wang  9 , Hong-Xia Xu  10 , Han-Ping Shi  11   12   13 ; Investigation on Nutrition Status and its Clinical Outcome of Common Cancers (INSCOC) Group
Affiliations
Observational Study

PG-SGA SF in nutrition assessment and survival prediction for elderly patients with cancer

Qi Zhang et al. BMC Geriatr. .

Abstract

Background: This study was sought to report the prevalence of malnutrition in elderly patients with cancer. Validate the predictive value of the nutritional assessment tool (Patient-Generated Subjective Global Assessment Short Form, PG-SGA SF) for clinical outcomes and assist the therapeutic decision.

Methods: This is a secondary analysis of a multicentric, observational cohort study. Elderly patients with cancer older than 65 years were enrolled after the first admission. Nutritional status was identified using the PG-SGA SF.

Results: Of the 2724 elderly patients included in the analysis, 65.27% of patients were male (n = 1778); the mean age was 71.00 ± 5.36 years. 31.5% of patients were considered malnourished according to PG-SGA SF. In multivariate analysis, malnutrition(PG-SGA SF > 5) was significantly associated with worse OS (HR: 1.47,95%CI:1.29-1.68), affects the quality of life, and was related to more frequent nutrition impact symptoms. During a median follow-up of 4.5 years, 1176 death occurred. The mortality risk was 41.10% for malnutrition during the first 12 months and led to a rate of 323.98 events per-1000-patient-years. All nutritional assessment tools were correlated with each other (PG-SGA SF vs. PG-SGA: r = 0.98; PG-SGA SF vs. GLIM[Global Leadership Initiative on Malnutrition]: r = 0.48, all P < 0.05). PG-SGA SF and PG-SGA performed similarly to predict mortality but better than GLIM. PG-SGA SF improves the predictive ability of the TNM classification system for mortality in elderly patients with cancer, including distinguishing patients' prognoses and directing immunotherapy.

Conclusions: The nutritional status as measured by PG-SGA SF which is a prognostic factor for OS in elderly cancer patients and could improve the prognostic model of TNM.

Keywords: Cancer; Elderly patients; Malnutrition; Nutrition assessment; PG-SGA SF.

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Conflict of interest statement

The author(s) indicate no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
The relationship between PG-SGA SF and OS. A The incidence of all-cause mortality is shown after adjusted for gender, age, smoking, alcohol, tumors type, TNM stage, surgery, radiotherapy, and chemotherapy, KPS, A/B, NLR, and HGS. The x-axis shows the score of malnutrition indexes (PG-SGA SF). The curve shows the incidence, with 95% confidence intervals, of the estimates. Histograms show the population distribution of malnutrition indexes. B Kaplan-Meier curves for all-cause mortality by the cut-off point of PG-SGA SF (> 5) in elderly patients with cancer
Fig. 2
Fig. 2
calibration plot and decision curve analysis for PG-SGA SF. A Calibration curves of the TNM stage combined with PG-SGA SF model. B Decision curve analysis on the TNM stage (black line), and TNM stage combined with PG-SGA SF (red line). Gray line denotes the assumption that all patients have outcome event (death) during follow-up. Thick black line represents the assumption that no patients have outcome event (death) during follow-up
See this image and copyright information in PMC

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