Predicting 10-year survival in early and locally advanced breast cancer: prognostic value of nutritional status and body composition

IF 3.6 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2026-06-01 Epub Date: 2026-01-24 DOI:10.1016/j.nut.2026.113133

Derya Hopanci Bicakli Ph.D., R.D. , Asli Gecgel M.D. , Oguzcan Ozkan M.D. , Atalay Aktuna M.D. , Mert İsci M.D. , Pinar Gursoy M.D.

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引用次数: 0

Abstract

Aim

This study aimed to evaluate the prognostic impact of nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and body composition parameters on 10-year overall survival (OS) in patients with early and locally advanced breast cancer.

Methods

This retrospective longitudinal study included 437 women aged over 18 years diagnosed with stage I–III breast cancer between 2015-2017. Patients with metastatic disease at diagnosis or incomplete data were excluded. Nutritional status was assessed using PG-SGA. Body composition was measured via bioelectrical impedance analysis. Clinical data and antropometric measuremets were collected from electronic medical records. ROC analysis identified cut-off values, and Kaplan-Meier and Cox regression analyses evaluated the impact of nutrition and body composition on OS.

Results

The median follow-up was 117.7 months (mean 121.2 ± 51.1 months). PG-SGA cut-off value of 5.5 effectively stratified patients into low- and high-risk nutritional groups. Higher PG-SGA scores were significantly associated with poorer OS (HR = 1.057; 95% CI: 1.021–1.094; p = .002). Anthropometric measurements including calf circumference, mid-arm circumference, skinfold thickness, body mass index (BMI), fat-free mass, and muscle mass predicted survival outcomes (all p < .05). Patients with PG-SGA ≥5.5 had a median survival of 145.8 months (95% CI: 130.3–161.4), compared to 285.7 months (95% CI: 267.9–303.5) in those with lower scores (p < .001). Similarly, higher body composition metrics correlated with significantly longer survival. Multivariate analysis confirmed PG-SGA and body composition parameters as independent prognostic factors, adjusting for age, stage, disease progression (defined as the development of distant metastases during follow-up), and receipt of systemic treatment during follow-up.

Conclusion

Nutritional status and body composition are valuable predictors of long-term survival in early and locally advanced breast cancer. Defining a PG-SGA threshold in this setting, our study highlights the importance of integrating nutritional assessment into routine care, even beyond advanced disease.

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预测早期和局部晚期乳腺癌的10年生存率：营养状况和身体成分的预后价值。

目的：本研究旨在评估患者主观整体评估（PG-SGA）评估的营养状况和身体成分参数对早期和局部晚期乳腺癌患者10年总生存期（OS）的预后影响。方法：本回顾性纵向研究纳入了437名年龄在18岁以上的2015-2017年间诊断为I-III期乳腺癌的女性。排除诊断时有转移性疾病或资料不完整的患者。采用PG-SGA评估营养状况。通过生物电阻抗分析测定体成分。从电子病历中收集临床资料和心肺测量数据。ROC分析确定了截止值，Kaplan-Meier和Cox回归分析评估了营养和身体成分对OS的影响。结果：中位随访时间为117.7个月（平均121.2±51.1个月）。PG-SGA临界值为5.5有效地将患者分为低、高风险营养组。PG-SGA评分越高，OS越差（HR = 1.057; 95% CI: 1.021-1.094; p = 0.002）。人体测量测量包括小腿围、臂中围、皮褶厚度、体重指数（BMI）、无脂质量和肌肉质量预测生存结果（均p < 0.05）。PG-SGA≥5.5的患者中位生存期为145.8个月（95% CI: 130.3-161.4），而评分较低的患者中位生存期为285.7个月（95% CI: 267.9-303.5）（p < 0.001）。同样，较高的身体成分指标与较长的生存期显著相关。多因素分析证实PG-SGA和身体成分参数是独立的预后因素，调整了年龄、分期、疾病进展（定义为随访期间远处转移的发展）和随访期间接受全身治疗的情况。结论：营养状况和身体成分是早期和局部晚期乳腺癌患者长期生存的重要预测指标。在这种情况下，我们的研究定义了PG-SGA阈值，强调了将营养评估纳入常规护理的重要性，甚至超过了晚期疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.