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Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer

PURPOSE: In addition to tumor factors, poor nutritional status before and during anti-tumor treatment might compromise prognosis in several types of cancer. This study was done to determine the impact of weight loss during preoperative chemoradiotherapy (CRT) on the survival outcome of patients with...

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Autores principales: Lin, Junzhong, Peng, Jianhong, Qdaisat, Aiham, Li, Liren, Chen, Gong, Lu, Zhenhai, Wu, Xiaojun, Gao, Yuanhong, Zeng, Zhifan, Ding, Peirong, Pan, Zhizhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095158/
https://www.ncbi.nlm.nih.gov/pubmed/27613188
http://dx.doi.org/10.1007/s00432-016-2225-1
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author Lin, Junzhong
Peng, Jianhong
Qdaisat, Aiham
Li, Liren
Chen, Gong
Lu, Zhenhai
Wu, Xiaojun
Gao, Yuanhong
Zeng, Zhifan
Ding, Peirong
Pan, Zhizhong
author_facet Lin, Junzhong
Peng, Jianhong
Qdaisat, Aiham
Li, Liren
Chen, Gong
Lu, Zhenhai
Wu, Xiaojun
Gao, Yuanhong
Zeng, Zhifan
Ding, Peirong
Pan, Zhizhong
author_sort Lin, Junzhong
collection PubMed
description PURPOSE: In addition to tumor factors, poor nutritional status before and during anti-tumor treatment might compromise prognosis in several types of cancer. This study was done to determine the impact of weight loss during preoperative chemoradiotherapy (CRT) on the survival outcome of patients with locally advanced rectal cancer (LARC). METHODS: The retrospective study examined consecutive patients with LARC who underwent preoperative CRT followed by radical resection in a single institute, between 2003 and 2013. Correlation of proportional body mass index (BMI) change after preoperative CRT and patient’s demographics, tumor characteristics, treatment parameters, CRT-related toxicity, disease-free survival (DFS) and overall survival (OS) were investigated. RESULTS: A total of 364 patients were enrolled, and BMI loss was found in 243 patients (66.2 %) after preoperative CRT. Severe weight loss (SWL) was defined as BMI loss ≥7 %. Thirty-nine (10.7 %) cases were enrolled in SWL cohort and found to have higher incidence of diarrhea (P = 0.033), renal disorder (P = 0.033) and grade 3–4 radiation proctitis (P = 0.041). Although no significant difference was found in 3-year DFS, patients in SWL cohort showed significantly worse 3-year OS rate (71.8 vs 88.0 %, P = 0.030) than the others. In univariate analysis, BMI loss ≥7 %, completed dose of preoperative chemotherapy, pathologic T and N stages were correlated with OS (all P < 0.05). In multivariable analysis, BMI loss ≥7 % (HR 1.984; 95 % CI 1.061–3.709; P = 0.032) remained the independent prognostic factor for OS. CONCLUSIONS: Our results demonstrate that SWL during preoperative CRT indeed compromises survival outcome in patients with LARC. Routine nutritional monitoring and nutritional support during preoperative CRT are suggested as the integral part of the multidisciplinary approach for these patients.
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spelling pubmed-50951582016-11-17 Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer Lin, Junzhong Peng, Jianhong Qdaisat, Aiham Li, Liren Chen, Gong Lu, Zhenhai Wu, Xiaojun Gao, Yuanhong Zeng, Zhifan Ding, Peirong Pan, Zhizhong J Cancer Res Clin Oncol Original Article – Clinical Oncology PURPOSE: In addition to tumor factors, poor nutritional status before and during anti-tumor treatment might compromise prognosis in several types of cancer. This study was done to determine the impact of weight loss during preoperative chemoradiotherapy (CRT) on the survival outcome of patients with locally advanced rectal cancer (LARC). METHODS: The retrospective study examined consecutive patients with LARC who underwent preoperative CRT followed by radical resection in a single institute, between 2003 and 2013. Correlation of proportional body mass index (BMI) change after preoperative CRT and patient’s demographics, tumor characteristics, treatment parameters, CRT-related toxicity, disease-free survival (DFS) and overall survival (OS) were investigated. RESULTS: A total of 364 patients were enrolled, and BMI loss was found in 243 patients (66.2 %) after preoperative CRT. Severe weight loss (SWL) was defined as BMI loss ≥7 %. Thirty-nine (10.7 %) cases were enrolled in SWL cohort and found to have higher incidence of diarrhea (P = 0.033), renal disorder (P = 0.033) and grade 3–4 radiation proctitis (P = 0.041). Although no significant difference was found in 3-year DFS, patients in SWL cohort showed significantly worse 3-year OS rate (71.8 vs 88.0 %, P = 0.030) than the others. In univariate analysis, BMI loss ≥7 %, completed dose of preoperative chemotherapy, pathologic T and N stages were correlated with OS (all P < 0.05). In multivariable analysis, BMI loss ≥7 % (HR 1.984; 95 % CI 1.061–3.709; P = 0.032) remained the independent prognostic factor for OS. CONCLUSIONS: Our results demonstrate that SWL during preoperative CRT indeed compromises survival outcome in patients with LARC. Routine nutritional monitoring and nutritional support during preoperative CRT are suggested as the integral part of the multidisciplinary approach for these patients. Springer Berlin Heidelberg 2016-09-09 2016 /pmc/articles/PMC5095158/ /pubmed/27613188 http://dx.doi.org/10.1007/s00432-016-2225-1 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article – Clinical Oncology
Lin, Junzhong
Peng, Jianhong
Qdaisat, Aiham
Li, Liren
Chen, Gong
Lu, Zhenhai
Wu, Xiaojun
Gao, Yuanhong
Zeng, Zhifan
Ding, Peirong
Pan, Zhizhong
Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
title Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
title_full Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
title_fullStr Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
title_full_unstemmed Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
title_short Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
title_sort severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
topic Original Article – Clinical Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095158/
https://www.ncbi.nlm.nih.gov/pubmed/27613188
http://dx.doi.org/10.1007/s00432-016-2225-1
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