TY - JOUR
T1 - The association between weight stability and parenteral nutrition characteristics and survival in patients with colorectal cancer
AU - Liu, Wenli
AU - Qdaisat, Aiham
AU - Lee, Eric
AU - Yeung, Jason
AU - Vu, Khanh
AU - Lin, Jun Zhong
AU - Canada, Todd
AU - Zhou, Shouhao
AU - Cohen, Lorenzo
AU - Bruera, Eduardo
AU - Yeung, Sai Ching J.
N1 - Funding Information:
The University of Texas MD Anderson Cancer Center was supported in part by the NIH through Cancer Center Support Grant P30 CA016672.
Funding Information:
Dr Yeung is the principal investigator of an investigator-initiated clinical trial supported by DepoMed and a retrospective clinical study supported by Bristol-Myers Squibb through ARISTA-USA (BMS/Pfizer American Thrombosis Investigator Initiated Research Program). Dr Lin is supported by the Sun Yat-sen University Cancer Center (Guangzhou, China). We thank the Department of Scientific Publications at MD Anderson Cancer Center for manuscript editing. This study was conducted under approved clinical research protocols and was in compliance with ethical standards for human research and HIPAA regulations.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Objective: Knowledge about the impact of metabolic disturbances and parenteral nutrition (PN) characteristics on the survival of cancer patients receiving PN is limited. We aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN support. Methods: Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and 2013. Patient characteristics, body mass index, weight, medical/surgical history, indication for PN, PN data and survival were recorded. Associations between clinical and PN characteristics and survival were analysed with important confounding factors. Results: The final cohort included 437 evaluable patients, with a mean age of 57 years. Eighty-one percent of the study population had advanced stage of colorectal cancer. Unstable weight (weight change >2.5%) prior to PN initiation [hazard ratio (HR) = 1.41, P = 0.023] was adversely associated with survival after adjusting for multiple factors including cancer stage. Bowel obstruction (HR = 1.75, P = 0.017) as a PN indication was associated with worse survival when compared with without bowel obstruction. Higher PN amino acid by ideal body weight (g·kg-1) (HR = 0.59, P = 0.029) was associated with longer survival, whereas a higher percentage of non-PN intravenous calories (HR = 1.04, P = 0.011) was associated with shorter survival independently of confounding factors. Conclusions: Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving PN. PN planning should take into account of non-PN calories to achieve optimal energy support and balance. Future research is needed to define optimal PN amino-acid requirement and energy balance.
AB - Objective: Knowledge about the impact of metabolic disturbances and parenteral nutrition (PN) characteristics on the survival of cancer patients receiving PN is limited. We aimed to assess the association between clinical and PN characteristics and survival in colorectal-cancer patients receiving PN support. Methods: Our study included 572 consecutive colorectal-cancer patients who had received PN support between 2008 and 2013. Patient characteristics, body mass index, weight, medical/surgical history, indication for PN, PN data and survival were recorded. Associations between clinical and PN characteristics and survival were analysed with important confounding factors. Results: The final cohort included 437 evaluable patients, with a mean age of 57 years. Eighty-one percent of the study population had advanced stage of colorectal cancer. Unstable weight (weight change >2.5%) prior to PN initiation [hazard ratio (HR) = 1.41, P = 0.023] was adversely associated with survival after adjusting for multiple factors including cancer stage. Bowel obstruction (HR = 1.75, P = 0.017) as a PN indication was associated with worse survival when compared with without bowel obstruction. Higher PN amino acid by ideal body weight (g·kg-1) (HR = 0.59, P = 0.029) was associated with longer survival, whereas a higher percentage of non-PN intravenous calories (HR = 1.04, P = 0.011) was associated with shorter survival independently of confounding factors. Conclusions: Body mass index and weight stability can be useful nutritional indices for survival prediction in cancer patients receiving PN. PN planning should take into account of non-PN calories to achieve optimal energy support and balance. Future research is needed to define optimal PN amino-acid requirement and energy balance.
KW - BMI
KW - Energy balance
KW - Non-parenteral calorie
KW - Parenteral nutrition
KW - Weight loss
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U2 - 10.1093/gastro/goz021
DO - 10.1093/gastro/goz021
M3 - Article
C2 - 31857903
AN - SCOPUS:85079506576
SN - 2052-0034
VL - 7
SP - 419
EP - 425
JO - Gastroenterology Report
JF - Gastroenterology Report
IS - 6
ER -