The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy

Background: Chemotherapy is frequently used for palliation inpatients with advanced gastrointestinal (GI) cancer and improvements in quality of life (QoL) and survival are documented. Several pre-treatment factors, particularly poor performance status, influence the outcomes. The relative importance of nutrition-associated factors is less well known. Patients and Methods: Data from 152 patients treated within four randomised studies were analysed to explore the relations between weight loss, nutrition-associated parameters, performance status, response to chemotherapy, global QoL and survival. Results: Patients with weight loss, poor performance, higher frequency of nutritional problems and low haemoglobin levels had a lower probability of responding to treatment. Global QoL was decreased in patients having weight loss as well as problems with pain or fatigue. Diagnosis had the strongest association to survival. In a multivariate analysis poor performance and weight loss were also independently related to survival. Conclusion: Weight loss and several nutrition-associated problems were associated with lower QoL, less likelihood to respond to chemotherapy and poor survival.