Supportive Care in Cancer

, Volume 17, Issue 10, pp 1263–1268 | Cite as

Effects of nutritional and psychological status of the patients with advanced stomach cancer on physical performance status

Original Article


Goals of the work

The aim of this study was to assess the associations between coping mode, nutritional status, and psychological status and performance status of the patients with advanced stomach cancer.

Materials and methods

An epidemiological survey was conducted among 233 patients with advanced stomach cancer in Fujian, China. In-person interviews were performed for the participants with respect to information of psychological status prior to chemotherapy, nutritional status during chemotherapy, and physical performance status after chemotherapy.

Main results

Multivariate logistic regression analyses showed that the level of hemoglobin (HB), level of daily calorie intake, score of Depression Status Inventory (DSI), and score of confrontation subscale of Medical Coping Modes Questionnaire had a significant influence on performance status (P < 0.05). The relative risks (95% confidence interval) were 2.06 (1.12–3.79) for low level of hemoglobin versus normal level of hemoglobin, 1.16 (1.02–1.32) for low level of daily calorie intake versus normal level of daily calorie intake, 5.89 (2.00–17.31) for DSI score ≥40 versus DSI score <40, and 3.17 (1.73–5.78) for low score of confrontation versus high score of confrontation, respectively.


Depression, low score of “Confrontation”, low levels of HB, and low level of daily calorie intake may be the risk factors of poor performance status of the patients with advanced stomach cancer.


Nutritional status Psychological status Performance status Stomach cancer Epidemiological survey 


  1. 1.
    Alexandre J, Gross-Goupil M, Falissard B et al (2003) Evaluation of the nutritional and inflammatory status in cancer patients for the risk assessment of severe haematological toxicity following chemotherapy. Ann Oncol 14:36–41. doi: 10.1093/annonc/mdg013 PubMedCrossRefGoogle Scholar
  2. 2.
    Akechi T, Okamura H, Yamawaki S et al (1998) Predictors of patients’mental adjustment to cancer: patient characteristics and social support. Br J Cancer 77:2381–2385PubMedGoogle Scholar
  3. 3.
    Badger TA, Braden CJ, Mishel MH (2001) Depression burden, self-help interventions, and side effect experience in women receiving treatment for breast cancer. Oncol Nurs Forum 28(3):567–574PubMedGoogle Scholar
  4. 4.
    Bauer JD, Capra S (2005) Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy—a pilot study. Support Care Cancer 13:270–274. doi: 10.1007/s00520-004-0746-7 PubMedCrossRefGoogle Scholar
  5. 5.
    Bauer J, Capra S, Ferguson M (2002) Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785. doi: 10.1038/sj.ejcn.1601412 PubMedCrossRefGoogle Scholar
  6. 6.
    Brown DJ, McMillan DC, Milroy R (2005) The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer. Cancer 103(2):377–382. doi: 10.1002/cncr.20777 PubMedCrossRefGoogle Scholar
  7. 7.
    Burrows J, Lammersfeld C, Dahlk S et al (2004) Impact of self-reported performance status on survival in advanced colorectal cancer. J Clin Oncol 22(14S):3761–3762Google Scholar
  8. 8.
    Cella D (1998) Factors influencing quality of life in cancer patients: anemia and fatigue. Semin Oncol 25:43–46PubMedGoogle Scholar
  9. 9.
    Cella DF, Orofiamma B, Holland JC et al (1987) The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer. Cancer 60(7):1661–1667. doi: 10.1002/1097-0142(19871001)60:7<1661::AID-CNCR2820600740>3.0.CO;2-4 PubMedCrossRefGoogle Scholar
  10. 10.
    Cunningham AJ, Watson K (2004) How psychological therapy may prolong survival in cancer patients: new evidence and a simple theory. Integr Cancer Ther 3(3):214–229. doi: 10.1177/1534735404267553 PubMedCrossRefGoogle Scholar
  11. 11.
    Faller H, Bulzebruck H, Drings P et al (1999) Coping, distress, and survival among patients with lung cancer. Arch Gen Psychiatry 56:756–762. doi: 10.1001/archpsyc.56.8.756 PubMedCrossRefGoogle Scholar
  12. 12.
    Guo HW (2002) Medical nutrition. Fudan University Press, Shanghai, pp 2–68Google Scholar
  13. 13.
    Hyde SE, Ansink AC et al (2002) The impact of performance status on survival in patients of 80 years and older with vulvar cancer. Gynecol Oncol 84:388–393. doi: 10.1006/gyno.2001.6531 PubMedCrossRefGoogle Scholar
  14. 14.
    Maltoni M, Nanni O, Derni S et al (1994) Clinical prediction of survival is more accurate than the Karnofsky Performance Status in estimating life span of terminally ill cancer patients. Eur J Cancer 30A:764–766. doi: 10.1016/0959-8049(94)90289-5 PubMedCrossRefGoogle Scholar
  15. 15.
    Maltoni M, Pirovano M, Scarpi E et al (1995) Prediction of survival of patients terminally ill with cancer: results of an Italian prospective multicentric study. Cancer 75:2613–2622. doi: 10.1002/1097-0142(19950515)75:10<2613::AID-CNCR2820751032>3.0.CO;2-1 PubMedCrossRefGoogle Scholar
  16. 16.
    McMillan DC, Forrest LM (2002) Performance status of male and female advanced cancer patients is independently predicted by mid-upper arm circumference measurement. Nutr Cancer 42(2):191–193. doi: 10.1207/S15327914NC422_7 PubMedCrossRefGoogle Scholar
  17. 17.
    Nakaya N, Saito-Nakaya K, Akizuki N, Yoshikawa E, Kobayakawa M, Fujimori M et al (2006) Depression and survival in patients with non-small cell lung cancer after curative resection: a preliminary study. Cancer Sci 97(3):199–205. doi: 10.1111/j.1349-7006.2006.00160.x PubMedCrossRefGoogle Scholar
  18. 18.
    Okano Y, Okamura H, Watanabe T et al (2001) Mental adjustment to first recurrence and correlated factors in patients with breast cancer. Breast Cancer Res Treat 67:255–262. doi: 10.1023/A:1017942709369 PubMedCrossRefGoogle Scholar
  19. 19.
    Glare P (2005) Clinical predictors of survival in advanced cancer. J Support Oncol 3(5):331–339PubMedGoogle Scholar
  20. 20.
    Reuben DB, Mor V, Hiris J (1988) Clinical symptoms and length of survival in patients with terminal cancer. Arch Intern Med 148:1586–1591. doi: 10.1001/archinte.148.7.1586 PubMedCrossRefGoogle Scholar
  21. 21.
    RRosenthal MA Gebski VJ, Kefford RF, Stuart-Harris RC (1993) Prediction of life-expectancy in hospice patients: identification of novel prognostic factors. Palliat Med 7:199–204. doi: 10.1177/026921639300700306 CrossRefGoogle Scholar
  22. 22.
    Schnadig ID, Fromme EK, Loprinzi CL et al (2008) Patient–physician disagreement regarding performance status is associated with worse survivorship in patients with advanced cancer. Cancer 113(8):2205–2214. doi: 10.1002/cncr.23856 PubMedCrossRefGoogle Scholar
  23. 23.
    Spielberger CD (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto, CAGoogle Scholar
  24. 24.
    Boeck A Hinke S, Wilkowski R, Heinemann V (2007) Importance of performance status for treatment outcome in advanced pancreatic cancer. World J Gastroenterol 13(2):224–227Google Scholar
  25. 25.
    Tian J, Chen ZC, Hang LF (2007) Effects of nutritional and psychological status of gastrointestinal cancer patients on tolerance of the cancer treatments. World J Gastroenterol 13(30):4136–4140PubMedGoogle Scholar
  26. 26.
    Wan GJ, Counte MA, Cella DF (1996) The relationship between performance status, socio-cultural factors and health-related quality of life in breast cancer patients. AHSR FHSR Annu Meet Abstr Book 13:197–198Google Scholar
  27. 27.
    Wang XD, Wang XL, Ma Hong (1999) Rating scales for mental health. Zhongguo xingli Weisheng Zazhi PressGoogle Scholar
  28. 28.
    Yan H, Sellick K (2004) Quality of life of Chinese patients newly diagnosed with gastrointestinal cancer: a longitudinal study. Int J Nurs Stud 41(3):309–319. doi: 10.1016/j.ijnurstu.2003.10.004 PubMedCrossRefGoogle Scholar
  29. 29.
    Zhao ZT (2000) Methods and application in epidemiologic research. Kexue, Beijing, pp 319–326Google Scholar
  30. 30.
    Zhou FL, Zhang WG, Wei YC, Xu KL, Hui LY, Wang XS, Li MZ (2005) Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers. World J Gastroenterol 11(15):2313–2318PubMedGoogle Scholar
  31. 31.
    Zung WWK (1976) Depression status inventory and self-rating depression scale. ECDEU Assessment Manual for Psychopharmacology. William GuyGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Department of Epidemiology and Health StatisticsFujian Medical UniversityFuzhouChina
  2. 2.Fujian Cancer HospitalFuzhouChina

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