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The relationship between nutritional status and prognosis in patients with locally advanced and advanced stage lung cancer

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Abstract

Purpose

The study aimed to determine the poor nutritional status, related factors, and its effect on the prognosis of patients with locally advanced and advanced stage lung cancer.

Methods

The study consisted of 539 patients, 412 (76.4%) of whom were non-small cell lung cancer (NSCLC), and 127 (23.6%) were small cell lung cancer (SCLC). The nutritional status of the patients was evaluated by the Controlling Nutritional Status (CONUT) and Prognostic Nutritional Index (PNI). Poor nutritional status was diagnosed with the CONUT score of ≥ 2 and PNI of ≥the median value. The factors related to nutritional status were determined using a multivariate logistic regression model. The effect of poor nutritional status on survival was calculated by Cox regression analysis.

Results

The median age was 64 years (29–87). Poor nutritional status was found in 56.4% (57.8% for NSCLC and 52.0% for SCLC) and 49.2% (51.5% for NSCLC and 41.7% for SCLC) of patients according to CONUT and PNI, respectively. The factors associated with poor nutritional status according to CONUT were age, gender, KPS < 80, and BMI < 18.5 for NSCLC and KPS for SCLC. According to PNI, only KPS < 80 was associated with poor nutritional status by the multivariate logistic regression model. The median overall survival significantly decreased with poor nutritional status according to CONUT and PNI in NSCLC (p < 0.001 and p < 0.001, respectively) and in SCLC (p = 0.05 and p = 0.007, respectively).

Conclusion

Poor nutritional status is a common factor associated with poor prognosis in patients with locally advanced and advanced stage lung cancer. Patients should be screened for nutritional status and supported.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Health Sciences Institute, Department of Nutrition and Dietetics, Istanbul Okan University, Istanbul, Turkey

    Busra Gul

  2. Medical Faculty, Department of Public Health, Eskisehir Osmangazi University, Eskisehir, Turkey

    Selma Metintas

  3. Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey

    Selma Metintas, Guntulu Ak & Muzaffer Metintas

  4. Medical Faculty, Department of Chest Diseases, Eskisehir Osmangazi University, Eskisehir, Turkey

    Guntulu Ak, Senay Yilmaz & Muzaffer Metintas

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  1. Busra Gul
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  2. Selma Metintas
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  3. Guntulu Ak
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  5. Muzaffer Metintas
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Correspondence to Guntulu Ak.

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The study was a retrospective study performed using the prospective lung cancer database of Eskisehir Osmangazi University Lung and Pleural Cancers Research and Clinical Center. Eskisehir Osmangazi University Ethical Committee approved the study (No: 22-01-2019/24).

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Gul, B., Metintas, S., Ak, G. et al. The relationship between nutritional status and prognosis in patients with locally advanced and advanced stage lung cancer. Support Care Cancer 29, 3357–3365 (2021). https://doi.org/10.1007/s00520-020-05856-5

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  • DOI: https://doi.org/10.1007/s00520-020-05856-5

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