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Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma
BACKGROUND: Although commonly observed, malnutrition is poorly characterized and frequently underdiagnosed in patients with metastatic renal cell carcinoma (RCC). The ability of nutritional screening tools to predict overall survival (OS) in patients with RCC has not been adequately validated. The o...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575553/ https://www.ncbi.nlm.nih.gov/pubmed/26401468 http://dx.doi.org/10.1002/jcsm.12025 |
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author | Gu, Weijie Zhang, Guiming Sun, Lijiang Ma, Qi Cheng, Yue Zhang, Hailiang Shi, Guohai Zhu, Yao Ye, Dingwei |
author_facet | Gu, Weijie Zhang, Guiming Sun, Lijiang Ma, Qi Cheng, Yue Zhang, Hailiang Shi, Guohai Zhu, Yao Ye, Dingwei |
author_sort | Gu, Weijie |
collection | PubMed |
description | BACKGROUND: Although commonly observed, malnutrition is poorly characterized and frequently underdiagnosed in patients with metastatic renal cell carcinoma (RCC). The ability of nutritional screening tools to predict overall survival (OS) in patients with RCC has not been adequately validated. The objective of this study was to investigate the performance of nutritional screening tools and their additional prognostic value in patients with metastatic RCC treated with targeted therapies. METHODS: Patients were prospectively recruited from three tertiary hospitals between 2009 and 2013. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI) and the Mini Nutritional Assessment–Short Form (MNA–SF). Their OS and early grade 3/4 adverse events were recorded as outcomes of interest, and their associations with nutritional status were assessed using Cox regression and logistic regression, respectively. The incremental value in prognostication was evaluated using concordance index and decision curve analyses. RESULTS: Of the 300 enrolled patients, 95 (31.7%) and 64 (21.3%) were classified as being at risk of malnutrition according to the GNRI and MNA–SF, respectively. Both GNRI and MNA–SF were independent predictors of OS in multivariate analyses and provided significant added benefit to Heng risk classification. Compared with the MNA–SF, the GNRI contributed a higher increment to the concordance index (0.041 vs. 0.016). Nutritional screening, however, was not associated with early grade 3/4 adverse events in multivariate analyses. Further investigations are needed using more comprehensive and accurate assessment tools. CONCLUSIONS: This prospective study confirmed the importance of nutritional screening tools in survival prognostication in patients with metastatic RCC. The standardized and objective measurements would allow clinicians to identify metastatic RCC patients at risk of poor survival outcomes. Individualized nutritional assessment and intervention strategies may be included in the multidisciplinary treatment. |
format | Online Article Text |
id | pubmed-4575553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | John Wiley & Sons, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-45755532015-09-23 Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma Gu, Weijie Zhang, Guiming Sun, Lijiang Ma, Qi Cheng, Yue Zhang, Hailiang Shi, Guohai Zhu, Yao Ye, Dingwei J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: Although commonly observed, malnutrition is poorly characterized and frequently underdiagnosed in patients with metastatic renal cell carcinoma (RCC). The ability of nutritional screening tools to predict overall survival (OS) in patients with RCC has not been adequately validated. The objective of this study was to investigate the performance of nutritional screening tools and their additional prognostic value in patients with metastatic RCC treated with targeted therapies. METHODS: Patients were prospectively recruited from three tertiary hospitals between 2009 and 2013. Nutritional status was evaluated using the Geriatric Nutritional Risk Index (GNRI) and the Mini Nutritional Assessment–Short Form (MNA–SF). Their OS and early grade 3/4 adverse events were recorded as outcomes of interest, and their associations with nutritional status were assessed using Cox regression and logistic regression, respectively. The incremental value in prognostication was evaluated using concordance index and decision curve analyses. RESULTS: Of the 300 enrolled patients, 95 (31.7%) and 64 (21.3%) were classified as being at risk of malnutrition according to the GNRI and MNA–SF, respectively. Both GNRI and MNA–SF were independent predictors of OS in multivariate analyses and provided significant added benefit to Heng risk classification. Compared with the MNA–SF, the GNRI contributed a higher increment to the concordance index (0.041 vs. 0.016). Nutritional screening, however, was not associated with early grade 3/4 adverse events in multivariate analyses. Further investigations are needed using more comprehensive and accurate assessment tools. CONCLUSIONS: This prospective study confirmed the importance of nutritional screening tools in survival prognostication in patients with metastatic RCC. The standardized and objective measurements would allow clinicians to identify metastatic RCC patients at risk of poor survival outcomes. Individualized nutritional assessment and intervention strategies may be included in the multidisciplinary treatment. John Wiley & Sons, Ltd 2015-09 2015-04-20 /pmc/articles/PMC4575553/ /pubmed/26401468 http://dx.doi.org/10.1002/jcsm.12025 Text en © 2015 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society of Sarcopenia, Cachexia and Wasting Disorders http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Gu, Weijie Zhang, Guiming Sun, Lijiang Ma, Qi Cheng, Yue Zhang, Hailiang Shi, Guohai Zhu, Yao Ye, Dingwei Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
title | Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
title_full | Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
title_fullStr | Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
title_full_unstemmed | Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
title_short | Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
title_sort | nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575553/ https://www.ncbi.nlm.nih.gov/pubmed/26401468 http://dx.doi.org/10.1002/jcsm.12025 |
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