The prognosis of incurable cachectic cancer patients on home parenteral nutrition: a multi-centre observational study with prospective follow-up of 414 patients

被引：75

作者：

Bozzetti, F. ^{[1
]}

Santarpia, L. ^{[2
]}

Pironi, L. ^{[3
]}

Thul, P. ^{[4
]}

Klek, S. ^{[5
]}

Gavazzi, C. ^{[6
]}

Tinivella, M. ^{[7
]}

Joly, F. ^{[8
]}

Jonkers, C. ^{[9
]}

Baxter, J. ^{[10
]}

Gramlich, L. ^{[11
]}

Chicharro, L. ^{[12
]}

Staun, M. ^{[13
]}

Van Gossum, A. ^{[14
]}

Lo Vullo, S. ^{[15
]}

Mariani, L. ^{[15
]}

机构：

[1] Univ Milan, Fac Med, Milan, Italy

[2] Univ Naples Federico II, Dept Clin & Expt Med, Naples, Italy

[3] Univ Bologna, St Orsola Malpighi Hosp, Dept Gastroenterol & Internal Med, Bologna, Italy

[4] Humboldt Univ, Charite Campus Mitte, Dept Gen Visceral Vasc & Thorac Surg, D-10099 Berlin, Germany

[5] Stanley Dudrick Mem Hosp, Gen Surg Unit, Skawina, Poland

[6] Fdn IRCCS Ist Nazl Tumori, Unit Nutr Support, Milan, Italy

[7] AOU San Luigi Gonzaga, SSD Dietet Nutr Clin, Orbassano, Italy

[8] Rene Diderot Univ Paris, Beaujon Hosp, Dept Gastroenterol & Nutr Support, Paris, France

[9] Univ Amsterdam, Acad Med Ctr, Dept Dietet, NL-1105 AZ Amsterdam, Netherlands

[10] Kings Cross Community Care Ctr, Ctr Managed Clin Networks, Dundee, Scotland

[11] Univ Alberta, Dept Med, Div Gastroenterol, Edmonton, AB, Canada

[12] Hosp Valle De Hebron, Unidad Soporte Nutr, Barcelona, Spain

[13] Rigshosp, Dept Gastroenterol CA 2121, DK-2100 Copenhagen, Denmark

[14] Univ Libre Brussels, Erasme Hosp, Dept Gastroenterol, Clin Intestinal Dis & Nutr Support, Brussels, Belgium

[15] Fdn IRCCS Ist Nazl Tumori, Unit Clin Epidemiol & Trial Org, I-20133 Milan, Italy

来源：

ANNALS OF ONCOLOGY | 2014年 / 25卷 / 02期

关键词：

cancer cachexia; home parenteral nutrition; incurable cancer patient; malignant obstruction; LIFE; CACHEXIA; SUPPORT;

D O I：

10.1093/annonc/mdt549

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. We studied prospectively 414 incurable cachectic (sub)obstructed cancer patients receiving HPN and analysed the association between patient or clinical characteristics and surviving status. Median weight loss, versus pre-disease and last 6-month period, was 24% and 16%, respectively. Median body mass index was 19.5, median KPS was 60, median life expectancy was 3 months. Mean/median survival was 4.7/3.0 months; 50.0% and 22.9% of patients survived 3 and 6 months, respectively. At the multivariable analysis, the variables significantly associated with 3- and 6-month survival were Glasgow Prognostic Score (GPS) and KPS, and GPS, KPS and tumour spread, respectively. By the aggregation of the significant variables, it was possible to dissect several classes of patients with different survival probabilities. The outcome of cachectic incurable cancer patients on HPN is not homogeneous. It is possible to identify groups of patients with a >= 6-month survival (possibly longer than that allowed in starvation). The indications for HPN can be modulated on these clinical/biochemical indices.

引用

页码：487 / 493

页数：7

共 11 条

[1] ASPEN Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation [J].