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Cazelles A, Goere D. Posterior pelvic exenteration for cancer in women. J Visc Surg 2024; 161:41-46. [PMID: 38310075 DOI: 10.1016/j.jviscsurg.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Affiliation(s)
- Antoine Cazelles
- Department of general, digestive and endocrine surgery, Saint-Louis Hospital, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Diane Goere
- Department of general, digestive and endocrine surgery, Saint-Louis Hospital, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Rosebrock K, Sinn M, Uzunoglu FG, Bokemeyer C, Jensen W, Salchow J. Effects of Exercise Training on Patient-Specific Outcomes in Pancreatic Cancer Patients: A Scoping Review. Cancers (Basel) 2023; 15:5899. [PMID: 38136443 PMCID: PMC10741570 DOI: 10.3390/cancers15245899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND International guidelines have already highlighted the beneficial effects of exercise in common cancer entities. However, specific recommendations for pancreatic cancer are still missing. This scoping review aimed to evaluate the impact of exercise training on patient-specific outcomes in pancreatic cancer patients. METHODS A literature search was undertaken using PubMed, Web of Science, and Cochrane Library. We included randomized controlled trials (RCTs) published before August 2023 with structured exercise interventions during or after pancreatic cancer treatment. RESULTS Seven articles that prescribed home-based or supervised exercise with aerobic or resistance training or both were reviewed. The results indicate that exercise is feasible and safe in pancreatic cancer patients. Furthermore, exercise was associated with improved quality of life, cancer-related fatigue, and muscle strength. Concerning other outcomes, heterogeneous results were reported. We identified a lack of evidence, particularly for patients with advanced pancreatic cancer. CONCLUSION Exercise interventions in pancreatic cancer patients are feasible and can lead to improved quality of life, cancer-related fatigue, and muscle strength. However, further studies with larger sample sizes are needed to clarify the potential of exercise in pancreatic cancer, in particular for advanced stages.
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Mulliri A, Joubert M, Piquet MA, Alves A, Dupont B. Functional sequelae after pancreatic resection for cancer. J Visc Surg 2023; 160:427-443. [PMID: 37783613 DOI: 10.1016/j.jviscsurg.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The morbidity and mortality of pancreatic cancer surgery has seen substantial improvement due to the standardization of surgical techniques, the optimization of perioperative multidisciplinary management and the organization of specialized care systems. The identification and treatment of postoperative functional and nutritional sequelae have thereby become major issues in patients who undergo pancreatic surgery. This review addresses the functional sequelae of pancreatic resection for cancerous and pre-cancerous lesions (excluding chronic pancreatitis). Its aim is to specify the prevalence and severity of sequelae according to the type of pancreatic resection and to document, where appropriate, the therapeutic management. Exocrine pancreatic insufficiency (ExPI) is observed in nearly one out of three patients at one year after surgery, and endocrine pancreatic insufficiency (EnPI) is present in one out of five patients after pancreatoduodenectomy (PD) and one out of three patients after distal pancreatectomy (DP). In addition, digestive functional disorders may appear, such as delayed gastric emptying (DGE), which affects 10 to 45% of patients after PD and nearly 8% after DP. Beyond these functional sequelae, pancreatic surgery can also induce nutritional and vitamin deficiencies secondary to a lack of uptake for certain vitamins or to the loss of absorption site in the duodenum. In addition to the treatment of ExPI with oral pancreatic enzymes, nutritional management is based on a high-calorie, high-protein diet with normal lipid intake in frequent small feedings, combined with vitamin supplementation adapted to monitored deficiencies. Better knowledge of the functional consequences of pancreatic cancer surgery can improve the overall management of patients.
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Affiliation(s)
- Andrea Mulliri
- Digestive Surgery Department, University Hospital Center of Caen, Normandie Université, UNICAEN, 14000 Caen, France; Anticipe' U1086 Inserm-UCBN, 'Cancers & Preventions', Registre spécialisé des Tumeurs Digestives du Calvados, Team Labelled 'League Against Cancer', UNICAEN, Normandie Université, 14000 Caen, France
| | - Michael Joubert
- Diabetology-Endocrinology Department, University Hospital Center of Caen Normandie, Normandie Université, UNICAEN, 14000 Caen, France
| | - Marie-Astrid Piquet
- Department of Hepato-Gastroenterology and Nutrition, University Hospital Center of Caen Normandie, Normandie Université, UNICAEN, 14000 Caen, France
| | - Arnaud Alves
- Digestive Surgery Department, University Hospital Center of Caen, Normandie Université, UNICAEN, 14000 Caen, France; Anticipe' U1086 Inserm-UCBN, 'Cancers & Preventions', Registre spécialisé des Tumeurs Digestives du Calvados, Team Labelled 'League Against Cancer', UNICAEN, Normandie Université, 14000 Caen, France
| | - Benoît Dupont
- Anticipe' U1086 Inserm-UCBN, 'Cancers & Preventions', Registre spécialisé des Tumeurs Digestives du Calvados, Team Labelled 'League Against Cancer', UNICAEN, Normandie Université, 14000 Caen, France; Department of Hepato-Gastroenterology and Nutrition, University Hospital Center of Caen Normandie, Normandie Université, UNICAEN, 14000 Caen, France.
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De Moura A, Turpin A, Neuzillet C. [Nutritional supportive care in the course of patients with esophagogastric cancers]. Bull Cancer 2023; 110:540-551. [PMID: 36202638 DOI: 10.1016/j.bulcan.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/02/2022] [Accepted: 08/13/2022] [Indexed: 05/09/2023]
Abstract
Supportive care plays a central role in the management of patients with esophagogastric cancers, at all disease stages. Malnutrition has a high prevalence in this population, reaching up to 60 % of the patients. Sarcopenia and cachexia are also common. These complications have negative impact on functional abilities, quality of life and overall survival. They impair anti-tumor treatments effectiveness and increase their toxicity. Early detection and management are needed, before reaching advanced stages, which are refractory to therapeutic interventions. Specific nutritional support is recommended, relying on different nutritional support tools (dietetic counseling, oral supplements, artificial nutrition), depending on the clinical situation. When artificial nutrition is recommended, enteral nutrition (nasogastric tube, gastrostomy or jejunostomy) should be preferred. When enteral nutrition is impossible or insufficient, parenteral nutrition could be necessary. For patients with advanced esophagogastric cancers, digestive prostheses and decompressive radiation therapy may have a symptomatic benefit on dysphagia. Adapted physical activity is also recommended at all stages of cancer care and ongoing clinical trials will help to specify its modalities and to optimize its place in the therapeutic strategy. Finally, psychosocial support could be useful. A combined approach of these different interventions on the nutritional, physical and psychological aspects is beneficial for patients with esophagogastric cancers. This multimodal and multidisciplinary approach applies to both the early stages of the disease, with prehabilitation and/or rehabilitation to reduce perioperative morbidity and mortality and the advanced stages, with a benefit on survival and quality of life, in parallel with anti-tumor treatments.
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Affiliation(s)
- Alexandre De Moura
- Institut Curie, université Versailles Saint-Quentin, université Paris Saclay, département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.
| | - Anthony Turpin
- Université de Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277, CANTHER, Cancer heterogeneity plasticity and resistance to therapies, 59000 Lille, France
| | - Cindy Neuzillet
- Institut Curie, université Versailles Saint-Quentin, université Paris Saclay, département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France
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Torregrosa C, Chorin F, Beltran EEM, Neuzillet C, Cardot-Ruffino V. Physical Activity as the Best Supportive Care in Cancer: The Clinician's and the Researcher's Perspectives. Cancers (Basel) 2022; 14:5402. [PMID: 36358820 PMCID: PMC9655932 DOI: 10.3390/cancers14215402] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 08/11/2023] Open
Abstract
Multidisciplinary supportive care, integrating the dimensions of exercise alongside oncological treatments, is now regarded as a new paradigm to improve patient survival and quality of life. Its impact is important on the factors that control tumor development, such as the immune system, inflammation, tissue perfusion, hypoxia, insulin resistance, metabolism, glucocorticoid levels, and cachexia. An increasing amount of research has been published in the last years on the effects of physical activity within the framework of oncology, marking the appearance of a new medical field, commonly known as "exercise oncology". This emerging research field is trying to determine the biological mechanisms by which, aerobic exercise affects the incidence of cancer, the progression and/or the appearance of metastases. We propose an overview of the current state of the art physical exercise interventions in the management of cancer patients, including a pragmatic perspective with tips for routine practice. We then develop the emerging mechanistic views about physical exercise and their potential clinical applications. Moving toward a more personalized, integrated, patient-centered, and multidisciplinary management, by trying to understand the different interactions between the cancer and the host, as well as the impact of the disease and the treatments on the different organs, this seems to be the most promising method to improve the care of cancer patients.
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Affiliation(s)
- Cécile Torregrosa
- Oncologie Digestive, Département d’Oncologie Médicale Institut Curie, Université Versailles Saint-Quentin—Université Paris Saclay, 35, rue Dailly, 92210 Saint-Cloud, France
- Département de Chirurgie Digestive et Oncologique, Hôpital Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, 9 avenue Charles de Gaulle, 92100 Boulogne Billancourt, France
| | - Frédéric Chorin
- Laboratoire Motricité Humaine, Expertise, Sport, Santé (LAMHESS), HEALTHY Graduate School, Université Côte d’Azur, 06205 Nice, France
- Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06205 Nice, France
| | - Eva Ester Molina Beltran
- Oncologie Digestive, Département d’Oncologie Médicale Institut Curie, Université Versailles Saint-Quentin—Université Paris Saclay, 35, rue Dailly, 92210 Saint-Cloud, France
| | - Cindy Neuzillet
- Oncologie Digestive, Département d’Oncologie Médicale Institut Curie, Université Versailles Saint-Quentin—Université Paris Saclay, 35, rue Dailly, 92210 Saint-Cloud, France
- GERCOR, 151 rue du Faubourg Saint-Antoine, 75011 Paris, France
| | - Victoire Cardot-Ruffino
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Immunology, Harvard Medical School, Boston, MA 02215, USA
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Association of Low Handgrip Strength with Chemotherapy Toxicity in Digestive Cancer Patients: A Comprehensive Observational Cohort Study (FIGHTDIGOTOX). Nutrients 2022; 14:nu14214448. [PMID: 36364711 PMCID: PMC9654937 DOI: 10.3390/nu14214448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/25/2022] Open
Abstract
In the FIGHTDIGO study, digestive cancer patients with dynapenia experienced more chemotherapy-induced neurotoxicities. FIGHTDIGOTOX aimed to evaluate the relationship between pre-therapeutic handgrip strength (HGS) and chemotherapy-induced dose-limiting toxicity (DLT) or all-grade toxicity in digestive cancer patients. HGS measurement was performed with a Jamar dynamometer. Dynapenia was defined according to EWGSOP2 criteria (<27 kg (men); <16 kg (women)). DLT was defined as any toxicity leading to dose reduction, treatment delay, or permanent discontinuation. We also performed an exploratory analysis in patients below the included population’s median HGS. A total of 244 patients were included. According to EWGSOP2 criteria, 23 patients had pre-therapeutic dynapenia (9.4%). With our exploratory median-based threshold (34 kg for men; 22 kg for women), 107 patients were dynapenic (43.8%). For each threshold, dynapenia was not an independent predictive factor of overall DLT and neurotoxicity. Dynapenic patients according to EWGSOP2 definition experienced more hand-foot syndrome (p = 0.007). Low HGS according to our exploratory threshold was associated with more all-grade asthenia (p = 0.014), anemia (p = 0.006), and asthenia with DLT (p = 0.029). Pre-therapeutic dynapenia was not a predictive factor for overall DLT and neurotoxicity in digestive cancer patients but could be a predictive factor of chemotherapy-induced anemia and asthenia. There is a need to better define the threshold of dynapenia in cancer patients.
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Recommendations for nutritional assessment across clinical practice guidelines: A scoping review. Clin Nutr ESPEN 2022; 49:201-207. [PMID: 35623814 DOI: 10.1016/j.clnesp.2022.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS CPGs propose several methods and criteria to perform nutritional assessment, a key process to determine the type and severity of malnutrition, which generates variability in clinical practice and outcomes. The aim of the study was to describe the criteria considered by clinical practice guidelines (CPGs) for nutritional assessment. METHODS We performed a scoping review systematically searching in PubMed, Trip Database, Google Scholar, and Google, until November 5, 2021. We included all CPGs mentioning tools or criteria for nutritional assessment in adults from the general population or with any specific pathology or condition. Two authors independently reviewed and decided on study selection and data extraction. RESULTS We included 18 CPGs (12 elaborated in Europe). The CPGs recommended heterogeneous criteria for nutritional assessment: 16/18 CPGs included at least one body composition parameter (e.g., loss of muscle mass, loss of subcutaneous fat), 15/18 included history related to dietary intake, 15/18 included clinical history (e.g., weight loss), 10/18 included anthropometric measurement (e.g., low body mass index [BMI]), 11/18 included biochemical criteria (e.g., albumin, C-reactive protein), 8/18 included physical examination (e.g., fluid retention, sarcopenia, loss of subcutaneous fat), 8/18 included functional test (e.g., decreased handgrip strength), and 1/18 included catabolic state. Also, 9/18 CPGs mentioned a tool for nutritional assessment, the Subjective Global Assessment (SGA) the most common (8/18). None of the CPGs justified the inclusion of any of the tools or criteria they mentioned. CONCLUSIONS The CPGs mentioned heterogeneous criteria for nutritional assessment. The most commonly mentioned criteria were decreased food intake, loss of muscle mass, weight loss, and low BMI. The most mentioned tool was the SGA. None of the CPGs provided a clear rationale for using certain criteria or tools for nutritional assessment.
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Brugel M, Bouché O, Kianmanesh R, Teuma L, Tashkandi A, Regimbeau JM, Pessaux P, Royer B, Rhaiem R, Perrenot C, Neuzillet C, Piardi T, Deguelte S. Time from first seen in specialist care to surgery does not influence survival outcome in patients with upfront resected pancreatic adenocarcinoma. BMC Surg 2021; 21:413. [PMID: 34876080 PMCID: PMC8649990 DOI: 10.1186/s12893-021-01409-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND This study evaluated the impact of time to surgery (TTS) on overall survival (OS), disease free survival (DFS) and postoperative complication rate in patients with upfront resected pancreatic adenocarcinoma (PA). METHODS We retrospectively included patients who underwent upfront surgery for PA between January 1, 2004 and December 31, 2014 from four French centers. TTS was defined as the number of days between the date of the first consultation in specialist care and the date of surgery. DFS for a 14-day TTS was the primary endpoint. We also analyzed survival depending on different delay cut-offs (7, 14, 28, 60 and 75 days). RESULTS A total of 168 patients were included. 59 patients (35%) underwent an upfront surgery within 14 days. Patients in the higher delay group (> 14 days) had significantly more vein resections and endoscopic biliary drainage. Adjusted OS (p = 0.44), DFS (p = 0.99), fistulas (p = 0.41), hemorrhage (p = 0.59) and severe post-operative complications (p = 0.82) were not different according to TTS (> 14 days). Other delay cut-offs had no impact on OS or DFS. DISCUSSION TTS seems to have no impact on OS, DFS and 90-day postoperative morbidity.
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Affiliation(s)
- M. Brugel
- Department of Ambulatory Oncology Care Unit, Centre Hospitalier Universitaire de Reims, Rue du general Koenig, Reims, France
| | - O. Bouché
- Department of Ambulatory Oncology Care Unit, Centre Hospitalier Universitaire de Reims, Rue du general Koenig, Reims, France
- University Reims Champagne-Ardenne (URCA), Reims, France
| | - R. Kianmanesh
- University Reims Champagne-Ardenne (URCA), Reims, France
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
| | - L. Teuma
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
| | - A. Tashkandi
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
| | - J. M. Regimbeau
- Digestive Surgery Department, CHU Amiens Picardie, 1 rond-point du Professeur Christian Cabrol, Amiens, France
- University of Picardie Jules-Vernes, 51 boulevard de Chateaudun, Amiens, France
| | - P. Pessaux
- General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, 1 quai Louis Pasteur, Strasbourg, France
- Université de Strasbourg, Strasbourg, France
| | - B. Royer
- General Surgeon, Clinique de Courlancy, 38bis rue de Courlancy, Bezannes, France
| | - R. Rhaiem
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
| | - C. Perrenot
- University Reims Champagne-Ardenne (URCA), Reims, France
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
| | - C. Neuzillet
- Medical Oncology Department, Institut Curie, 35 rue Dailly, Saint-Cloud, France
- Versailles Saint-Quentin University, Paris Saclay University, Saint-Cloud, France
| | - T. Piardi
- University Reims Champagne-Ardenne (URCA), Reims, France
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
| | - S. Deguelte
- University Reims Champagne-Ardenne (URCA), Reims, France
- Digestive and Endocrine Surgery Department, Centre Hospitalier Universitaire de Reims, Rue du général Koenig, Reims, France
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Clinical nutrition as part of the treatment pathway of pancreatic cancer patients: an expert consensus. Clin Transl Oncol 2021; 24:112-126. [PMID: 34363594 PMCID: PMC8732873 DOI: 10.1007/s12094-021-02674-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022]
Abstract
Purpose Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients. Methods A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients. Results The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment. Conclusions There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients.
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Perrier M, Ordan MA, Barbe C, Mazza C, Botsen D, Moreau J, Renard Y, Brasseur M, Tailliere B, Regnault P, Bertin E, Bouche O. Dynapenia in digestive cancer outpatients: association with markers of functional and nutritional status (the FIGHTDIGO study). Support Care Cancer 2021; 30:207-215. [PMID: 34251540 DOI: 10.1007/s00520-021-06416-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/03/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The FIGHTDIGO study determined the feasibility and acceptability of handgrip strength (HGS) measurement in digestive cancer outpatients. PURPOSE To assess the relationship between muscle strength and markers of functional and nutritional status in this population. DESIGN In this prospective study, a total of 201 patients were followed during 6 months and were asked to perform HGS measurement at each hospitalization. Anthropometric measurements, laboratory tests, and performance status (PS) evaluation were collected. The modified Glasgow Prognostic Score (mGPS) was calculated using CRP and albumin levels. Severe malnutrition was defined as body mass index (BMI) < 18 kg/m2 in patients > 70 years old, and BMI < 16 kg/m2 in those < 70 years old. Dynapenia was defined as HGS < 30 kg (men) and < 20 kg (women). Mixed logistic regressions and mixed linear regressions were performed to study factors associated with dynapenia and HGS value, respectively. RESULTS A total of 879 HGS measurements were analyzed. Dynapenia occurred in 177 measurements (20.1%). BMI and HGS were significantly associated in univariate analysis (p = 0.001). In multivariate analysis, mGPS score (β = - 0.54 ± 0.31; p = 0.06) and severe malnutrition (β = - 2.8 ± 1.4; p = 0.08) tended to be associated with HGS. Dynapenia was only associated with functional status impairment in univariate analysis (n = 140/803, 17.4% in ECOG 0 and 1 versus n = 37/76, 58.7% in ECOG 2 and 3; p = 0.002). CONCLUSIONS Identification of dynapenia using HGS measurement may be useful to predict nutritional vulnerability in digestive cancer outpatients undergoing chemotherapy. Patients could then benefit from nutritional support, adapted physical activity programs, and early therapeutic adjustments. Trial registration ClinicalTrials.gov, NCT02797197.
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Affiliation(s)
- Marine Perrier
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France. .,Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France.
| | - Marie-Amelie Ordan
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France.,Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France
| | - Coralie Barbe
- Clinical Research Unit, Reims University Hospital, Reims, France
| | - Camille Mazza
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France
| | - Damien Botsen
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France
| | - Johanna Moreau
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France.,Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France
| | - Yohann Renard
- Department of General and Digestive Surgery, Reims University Hospital, Reims, France
| | - Mathilde Brasseur
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France.,Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France
| | | | - Philippe Regnault
- Mathematics Laboratory, UMR CNRS 9008, University of Reims Champagne Ardenne, Reims, France
| | - Eric Bertin
- Department of Nutrition, Endocrinology, and Diabetology, Reims University Hospital, Reims, France
| | - Olivier Bouche
- Ambulatory Cancer Unit, Reims University Hospital, Reims, France.,Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Avenue du General Koenig, 51092, Reims, France
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