Tori L McFarlane, James T Symanowski, Declan Walsh, Ye Myint Aung, Aynur Aktas, Michele L Szafranski, Jonathan C Salo, Patrick L Meadors, Kunal C Kadakia
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引用次数: 0
摘要
目的：营养不良严重影响对抗癌治疗的耐受性，但在美国，门诊患者实体瘤诊断时与总生存期（OS）的关系尚不清楚。方法：本回顾性研究评估了3562例在诊断时完成营养不良筛查工具（MST）的患者，确定MST风险（一种评估厌食症和体重减轻的有效工具）与OS之间的关系。MST评分≥2分为高营养不良风险（H-MST）。Kaplan-Meier技术和Cox比例风险模型用于分析H-MST与低营养不良风险（L-MST）的OS。结果：在未调整的模型中，MST风险与OS单独相关。多变量回归证实，在控制关键混杂变量后，MST风险仍然是OS的独立预后因素，HR=1.51 （95% CI: 1.33 ~ 1.72）。H-MST组的OS较短（50个月生存率：L-MST 69% vs H-MST 60%）。结论：诊断时MST风险是OS的独立预后因素。在一个广泛的实体肿瘤门诊患者队列中，H-MST风险与较短的生存期相关。
Malnutrition risk and overall survival at solid tumour diagnosis.
Purpose: Malnutrition severely impacts tolerance to anticancer therapies, but any relationship with overall survival (OS) at the time of solid tumour diagnosis in outpatients in the USA remains unclear.
Methods: This retrospective study evaluated 3562 patients who completed the Malnutrition Screening Tool (MST) at diagnosis, identifying the relationship between MST risk, a validated tool evaluating anorexia and weight loss, and OS. MST score of ≥2 of 5 was classified as high malnutrition risk (H-MST). Kaplan-Meier techniques and Cox proportional hazards models were used to analyse OS in H-MST versus low malnutrition risk (L-MST).
Results: In the unadjusted models, MST risk was individually associated with OS. Multivariable regression confirmed that MST risk remained independently prognostic for OS after controlling for key confounding variables, HR=1.51 (95% CI: 1.33 to 1.72). The H-MST group had shorter OS (50-month survival rates: 69% L-MST vs 60% H-MST).
Conclusion: MST risk at diagnosis is an independent prognostic factor for OS. H-MST risk is associated with shorter survival in a broad cohort of solid tumour oncology outpatients.
期刊介绍：
Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance.
We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication.
In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.
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