Assessment of nutritional status, performance status scores, Glasgow prognostic score and their relationship in advanced squamous carcinoma of the esophagus

Abstract

Background: Esophageal was the eighth of leading kinds of cancer all over the world and the incidence rate is increasing rapidly. Most of esophageal cancer patients present with late stages at the point of admissions, when they had malnutrition and dysphagia. There is a need for determination of the magnitude of poor nutrition status in these patients and find the other helpful indicators associated with it to help in clinical detection. Objectives: To determine the nutrition status of esophageal cancer patients and investigate the relationship between nutrition status, performance status scores and prognosis score. Subjects and methods: A clinical, cross-sectional study was conducted from August 2014 to February 2015 at National Cancer Hospital, Hanoi, Vietnam. Male esophageal cancer patients stage III/IV were assessed for nutritional status (patient-generated subjective global assessment-PG-SGA score), SGA, BMI, mid-arm circumference-MAC, energy and protein intakes, weight change), Karnofsky Performance Score (KPS) and Eastern Cooperative Oncology Group- ECOG, and Glasgow prognostic the incidence rate is increasing rapidly Results: Sixty-four male patients enrolled in the study. The mean ± SD of PG-SGA score was 9.88 ± 4.41. Forty-four% of patients had class B and 6.2% in class C by SGA. Using BMI, 43.8% patients were underweight. By MAC, 29.7% patients were undernourished. Patients having energy intakes below 25 kcal/kg/d were 54.7%, and 48.4% consumed protein below 1g/kg/d. Weight loss in the past two weeks, one month, and six months occurred in 68.8%, 84.4% and 92.2% patients, respectively. PG-SGA and SGA correlated well with KPS (r = -0.717 and 0.632; p <0.001) and ECOG (r = 0.672 and 0.626; p < 0.001) but weakly correlated with GPS (r = 0.332, p < 0.01 and 0.278, p < 0.05). KPS, ECOG, BMI, MAC, energy and protein intakes, and weight change did not correlate with GPS. Conclusions: Malnutrition, weight change, and insufficient energy and protein intakes were noteworthy in esophageal cancer patients. Good correlation between PG-SGA and SGA with performance status were documented and to a lesser extent with prognosis index.