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Are gastrointestinal problems, nutritional care, and nutritional care needs associated with quality of life in patients with advanced cancer? Results of the observational eQuiPe study

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Abstract

Purpose

To assess the association of gastrointestinal problems, received nutritional care, and nutritional care needs with quality of life (QoL) in patients with advanced cancer.

Methods

A cross-sectional analysis within the observational prospective eQuiPe cohort study on experienced quality of care and QoL in patients with advanced cancer was performed. QoL and gastrointestinal problems were measured using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30. Received nutritional care (yes/no) and nutritional care needs (yes/a little bit/no) were measured by two questions. Gastrointestinal problems were categorized as clinically important based on the Giesinger thresholds. Univariable and multivariable linear regression analyses adjusted for age, gender, and treatment were used to analyze the association of gastrointestinal problems, received nutritional care, and nutritional care needs with QoL.

Results

Half of the 1080 patients with advanced cancer had clinically important gastrointestinal problems, 17% experienced nutritional care needs, and 14% received nutritional care. Multivariable analyses revealed that the presence of clinically important gastrointestinal problems (β (95% CI): −13.0 (−15.6; −10.4)), received nutritional care (β (95% CI): −5.1 (−8.5; −1.7)), and nutritional care needs (β (95% CI): −8.7 (−11.9; −5.5)) were associated with a low QoL.

Conclusion

Many patients with advanced cancer experience gastrointestinal problems, while only few patients receive nutritional care. These gastrointestinal problems, nutritional care needs, and nutritional care are associated with lower QoL, probably due to reversed causality or the irreversible nature of these problems in the palliative phase. More research on the relation of nutritional care, gastrointestinal problems, and QoL is needed to optimize nutritional support in end-of-life care.

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Acknowledgements

We thank all patients for their time and effort in participating in our study while being in an uncertain situation. We also want to thank the participating hospitals for recruiting and informing patients and relatives about the eQuiPe study.

Data availability

Since 2011, PROFILES registry data is freely available according to the FAIR (Findable, Accessible, Interoperable, Reusable) data principles for non-commercial (international) scientific research, subject only to privacy and confidentiality restrictions. The datasets analyzed during the current study are available through Questacy (DDI 3.x XML) and can be accessed by our website (www.profilesregistry.nl). In order to arrange optimal long-term data warehousing and dissemination, we follow the quality guidelines that are formulated in the “Data Seal of Approval” (www.datasealofapproval.org) document, developed by Data Archiving and Networked Services (DANS). The data reported in this manuscript will be made available when the eQuiPe study is completed.

Funding

The eQuiPe study is funded by the Roparun Foundation.

Author information

Authors and Affiliations

  1. Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands

    Savvas Paschos, Nora Lize, Sandra Beijer, Natasja J. H. Raijmakers & Lonneke van de Poll-Franse

  2. Department of Epidemiology of the Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM) and Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands

    Simone Eussen

  3. Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands

    Annemieke van der Padt-Pruijsten

  4. Center of Expertise Palliative Care, Maastricht University Medical Center, Maastricht, the Netherlands

    Marieke van den Beuken-van Everdingen

  5. Amsterdam University Medical Centers, Department of Medical Oncology, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands

    Hanneke van Laarhoven

  6. Laurentius Hospital, Roermond, the Netherlands

    Marien den Boer

  7. Department of Medical Oncology, UMC Utrecht Medical Center, Utrecht, the Netherlands

    Alexander de Graeff

  8. Department of Pulmonology, Catharina Hospital, Eindhoven, the Netherlands

    Ben van den Borne

  9. Careyn, Utrecht, the Netherlands

    Herma ten Have

  10. Institution Verbeeten, Tilburg, the Netherlands

    Marjolanda Kennis

  11. General Practice Klein Vlijmen, Vlijmen, the Netherlands

    Marjolanda Kennis

  12. Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands

    Natasja J. H. Raijmakers

  13. Netherlands Cancer Institute, Amsterdam, the Netherlands

    Lonneke van de Poll-Franse

  14. CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands

    Lonneke van de Poll-Franse

Authors
  1. Savvas Paschos
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  14. Lonneke van de Poll-Franse
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Contributions

SP, NL, SE, SB, LP, and NR were involved in the study design. SP drafted the manuscript and performed the statistical analysis. All authors reviewed the manuscript and gave final approval of the manuscript.

Corresponding author

Correspondence to Natasja J. H. Raijmakers.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The study was reviewed by the Medical Research Ethics Committee of the Antoni van Leeuwenhoek hospital in the Netherlands (METC17.1491).

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Written informed consent was obtained from all individual participants included in the study.

Consent for publication

Written informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Paschos, S., Lize, N., Eussen, S. et al. Are gastrointestinal problems, nutritional care, and nutritional care needs associated with quality of life in patients with advanced cancer? Results of the observational eQuiPe study. Support Care Cancer 31, 189 (2023). https://doi.org/10.1007/s00520-023-07646-1

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