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BMC Cancer

, 16:900

Medical and radiation oncology


BackgroundMalnutrition in gastrectomized patients receiving chemotherapy is associated with the susceptibility to chemotherapy-related adverse events. This study evaluated pre-operative nutritional status-related indices associated with adverse events in post-operation gastric cancer patients receiving chemotherapy.

MethodsMedical records of 234 gastrectomized patients under adjuvant tegafur-gimeracil-oteracil chemotherapy with extended lymph node dissection were analyzed. Nutritional status assessment included Patient-Generated Subjective Global Assessment PG-SGA, body weight, body mass index, serum albumin concentration, and Nutrition Risk Index NRI. Chemotherapy-originated adverse events were determined using Common Terminology Criteria for Adverse Events.

ResultsPG-SGA indicated 59% of the patients were malnourished, and 27.8% of the patients revealed serious malnutrition with PG-SGA score of ≥9. Fifteen % of patients lost ≥10% of the initial body weight, 14.5% of the patients had hypoalbuminemia <3.5 g-dL, and 66.2% had NRI score less than 97.5 indicating moderate to severe malnutrition. Hematological adverse events were present in 94% ≥grade 1 and 16.2% ≥grade 3. Non-hematological adverse events occurred in 95.7% ≥grade1 and 16.7% ≥grade 3 of the patients. PG-SGA and NRI score was not associated with treatment-induced adverse events. Multivariate analyses indicated that female, low body mass index, and hypoalbuminemia were independent risk factors for grade 3-4 hematological adverse events. Age was an independent risk factor for grade 3-4 non-hematological adverse events. Neutropenia was the most frequently occurring adverse event, and associated risk factors were female, total gastrectomy, and hypoalbuminemia.

ConclusionsHypoalbuminemia, not PG-SGA or NRI may predict chemotherapy-induced adverse events in gastrectomized cancer patients.

KeywordsGastric cancer Malnutrition Chemotherapy Adverse events Hypoalbuminemia AbbreviationsBMIBody Mass Index

NRINutrition Risk Index

PG-SGAPatient-Generated Subjective Global Assessment

Electronic supplementary materialThe online version of this article doi:10.1186-s12885-016-2934-5 contains supplementary material, which is available to authorized users.

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Autor: Seung Hee Seo - Sung-Eun Kim - Yoon-Koo Kang - Baek-Yeol Ryoo - Min-Hee Ryu - Jae Ho Jeong - Shin Sook Kang - Mihi Yang


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