Supportive Care in Cancer

, Volume 19, Issue 2, pp 187–192 | Cite as

Standardized phase angle from bioelectrical impedance analysis as prognostic factor for survival in patients with cancer

  • Silvana Iturriet PaivaEmail author
  • Lúcia R. Borges
  • Denise Halpern-Silveira
  • M. Cecília F. Assunção
  • Aluisio J. D. Barros
  • M. Cristina Gonzalez
Original Article



Phase angle (PA), determined by bioelectrical impedance analysis (BIA), has been considered as a prognostic factor in several clinical conditions. The purpose of this study is to investigate PA, after adjusting for sex and age (standardized phase angle; SPA) as a prognostic factor for survival in cancer patients.


A prospective study was conducted in 195 patients before the first chemotherapy course. BIA was performed in all patients and SPA was calculated. The Kaplan-Meier method was used to calculate survival. The Cox regression method was used to evaluate the independent prognostic effect of PA after adjustment for other variables.


Patients with SPA < −1.65 had a smaller survival rate than those with SPA ≥ −1.65 (p < 0.001). Using Cox regression, the mortality rate was higher in patients with SPA < −1.65 (RR 3.12 CI: 2.03–4.79; p < 0.001). After multivariate analysis, patients with PA < −1.65 still presented a higher mortality rate (RR 2.35 CI: 1.41–3.90; p = 0.001).


The present study demonstrates that PA, used as SPA, is an independent prognostic indicator in this group of cancer patients receiving chemotherapy treatment even after adjustment for other prognostic variables.


Cancer Bioelectrical impedance analysis Phase angle Survival Prognostic marker Standardized phase angle 



We would like to thank the Oncology Center of Hospital Escola da Universidade Federal de Pelotas (FAU), RS, Brazil.

We would also like to thank to the CAPES, Ministry of Education, Brazil, for the scholarship during this research.

Conflict of interest

The authors have no conflict of interest to report.

Statement of authorship

SIP conceived the study, participated in its design and coordination, performed the data analysis, and wrote the manuscript. LRB and DHS performed part of the data collection. MCG participated in the design of the study, performed the statistical analysis and data analyses, and wrote the manuscript. MCFA and AJB reviewed the manuscript. All authors read and approved the final manuscript.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Silvana Iturriet Paiva
    • 1
    Email author
  • Lúcia R. Borges
    • 1
  • Denise Halpern-Silveira
    • 3
  • M. Cecília F. Assunção
    • 2
  • Aluisio J. D. Barros
    • 2
  • M. Cristina Gonzalez
    • 1
  1. 1.Post-graduate Program, Health and BehaviourCatholic University of PelotasPelotasBrazil
  2. 2.Post-graduate Program, EpidemiologyFederal University of PelotasPelotasBrazil
  3. 3.Faculty of NutritionFederal University of PelotasPelotasBrazil

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