Nutrition during trimodality treatment in stage III non-small cell lung cancer: Not only important for underweight patients

Barbara S van der Meij, Erik C J Phernambucq, Geert M Fieten, Egbert F Smit, Marinus A Paul, Paul A M van Leeuwen, J Wolter A Oosterhuis

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Abstract

INTRODUCTION: Trimodality treatment for stage III non-small cell lung cancer (NSCLC), consisting of chemoradiotherapy followed by surgery, is associated with treatment-related toxicity, malnutrition, and postoperative complications. The aim of this retrospective study was to investigate the predictive value of nutritional parameters on postoperative morbidity, mortality, and survival.

METHODS: Patients with stage III NSCLC undergoing concurrent chemoradiotherapy followed by surgery in one center between 2003 and 2009 were included. Age, sex, forced expiratory volume in 1 second, body mass index, weight change, and surgical and pathological factors were recorded and related to the occurrence of postoperative complications/mortality, overall survival (OS), and progression-free survival.

RESULTS: Of 51 study patients, 17 (33%) had overweight (body mass index ≥ 25) at start of treatment and 20 patients (39%) were malnourished at hospital admission for surgery. Postoperative complications occurred in 25 patients (49%), 6 had major complications, and 2 died within 90 days after surgery, but no significant predictive factors were found. Overall, weight loss ≥5% during induction period was associated with shorter OS (p = 0.03), but especially overweight patients experiencing weight loss ≥5% during induction period (n = 7) had shorter OS (hazard ratio 4.63, p = 0.005; log-rank p = 0.04) and progression-free survival (hazard ratio 6.03, p = 0.007).

CONCLUSIONS: This study indicates that malnutrition especially in overweight patients negatively influences survival outcomes of trimodality treatment for stage III NSCLC.

Original languageEnglish
Pages (from-to)1563-8
Number of pages6
JournalJournal of Thoracic Oncology
Volume6
Issue number9
DOIs
Publication statusPublished - Sep 2011
Externally publishedYes

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Thinness
Non-Small Cell Lung Carcinoma
Survival
Chemoradiotherapy
Malnutrition
Disease-Free Survival
Weight Loss
Body Mass Index
Therapeutics
Mortality
Nutritive Value
Forced Expiratory Volume
Ambulatory Surgical Procedures
Retrospective Studies
Morbidity
Weights and Measures

Cite this

van der Meij, Barbara S ; Phernambucq, Erik C J ; Fieten, Geert M ; Smit, Egbert F ; Paul, Marinus A ; van Leeuwen, Paul A M ; Oosterhuis, J Wolter A. / Nutrition during trimodality treatment in stage III non-small cell lung cancer : Not only important for underweight patients. In: Journal of Thoracic Oncology. 2011 ; Vol. 6, No. 9. pp. 1563-8.
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title = "Nutrition during trimodality treatment in stage III non-small cell lung cancer: Not only important for underweight patients",
abstract = "INTRODUCTION: Trimodality treatment for stage III non-small cell lung cancer (NSCLC), consisting of chemoradiotherapy followed by surgery, is associated with treatment-related toxicity, malnutrition, and postoperative complications. The aim of this retrospective study was to investigate the predictive value of nutritional parameters on postoperative morbidity, mortality, and survival.METHODS: Patients with stage III NSCLC undergoing concurrent chemoradiotherapy followed by surgery in one center between 2003 and 2009 were included. Age, sex, forced expiratory volume in 1 second, body mass index, weight change, and surgical and pathological factors were recorded and related to the occurrence of postoperative complications/mortality, overall survival (OS), and progression-free survival.RESULTS: Of 51 study patients, 17 (33{\%}) had overweight (body mass index ≥ 25) at start of treatment and 20 patients (39{\%}) were malnourished at hospital admission for surgery. Postoperative complications occurred in 25 patients (49{\%}), 6 had major complications, and 2 died within 90 days after surgery, but no significant predictive factors were found. Overall, weight loss ≥5{\%} during induction period was associated with shorter OS (p = 0.03), but especially overweight patients experiencing weight loss ≥5{\%} during induction period (n = 7) had shorter OS (hazard ratio 4.63, p = 0.005; log-rank p = 0.04) and progression-free survival (hazard ratio 6.03, p = 0.007).CONCLUSIONS: This study indicates that malnutrition especially in overweight patients negatively influences survival outcomes of trimodality treatment for stage III NSCLC.",
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Nutrition during trimodality treatment in stage III non-small cell lung cancer : Not only important for underweight patients. / van der Meij, Barbara S; Phernambucq, Erik C J; Fieten, Geert M; Smit, Egbert F; Paul, Marinus A; van Leeuwen, Paul A M; Oosterhuis, J Wolter A.

In: Journal of Thoracic Oncology, Vol. 6, No. 9, 09.2011, p. 1563-8.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Nutrition during trimodality treatment in stage III non-small cell lung cancer

T2 - Not only important for underweight patients

AU - van der Meij, Barbara S

AU - Phernambucq, Erik C J

AU - Fieten, Geert M

AU - Smit, Egbert F

AU - Paul, Marinus A

AU - van Leeuwen, Paul A M

AU - Oosterhuis, J Wolter A

PY - 2011/9

Y1 - 2011/9

N2 - INTRODUCTION: Trimodality treatment for stage III non-small cell lung cancer (NSCLC), consisting of chemoradiotherapy followed by surgery, is associated with treatment-related toxicity, malnutrition, and postoperative complications. The aim of this retrospective study was to investigate the predictive value of nutritional parameters on postoperative morbidity, mortality, and survival.METHODS: Patients with stage III NSCLC undergoing concurrent chemoradiotherapy followed by surgery in one center between 2003 and 2009 were included. Age, sex, forced expiratory volume in 1 second, body mass index, weight change, and surgical and pathological factors were recorded and related to the occurrence of postoperative complications/mortality, overall survival (OS), and progression-free survival.RESULTS: Of 51 study patients, 17 (33%) had overweight (body mass index ≥ 25) at start of treatment and 20 patients (39%) were malnourished at hospital admission for surgery. Postoperative complications occurred in 25 patients (49%), 6 had major complications, and 2 died within 90 days after surgery, but no significant predictive factors were found. Overall, weight loss ≥5% during induction period was associated with shorter OS (p = 0.03), but especially overweight patients experiencing weight loss ≥5% during induction period (n = 7) had shorter OS (hazard ratio 4.63, p = 0.005; log-rank p = 0.04) and progression-free survival (hazard ratio 6.03, p = 0.007).CONCLUSIONS: This study indicates that malnutrition especially in overweight patients negatively influences survival outcomes of trimodality treatment for stage III NSCLC.

AB - INTRODUCTION: Trimodality treatment for stage III non-small cell lung cancer (NSCLC), consisting of chemoradiotherapy followed by surgery, is associated with treatment-related toxicity, malnutrition, and postoperative complications. The aim of this retrospective study was to investigate the predictive value of nutritional parameters on postoperative morbidity, mortality, and survival.METHODS: Patients with stage III NSCLC undergoing concurrent chemoradiotherapy followed by surgery in one center between 2003 and 2009 were included. Age, sex, forced expiratory volume in 1 second, body mass index, weight change, and surgical and pathological factors were recorded and related to the occurrence of postoperative complications/mortality, overall survival (OS), and progression-free survival.RESULTS: Of 51 study patients, 17 (33%) had overweight (body mass index ≥ 25) at start of treatment and 20 patients (39%) were malnourished at hospital admission for surgery. Postoperative complications occurred in 25 patients (49%), 6 had major complications, and 2 died within 90 days after surgery, but no significant predictive factors were found. Overall, weight loss ≥5% during induction period was associated with shorter OS (p = 0.03), but especially overweight patients experiencing weight loss ≥5% during induction period (n = 7) had shorter OS (hazard ratio 4.63, p = 0.005; log-rank p = 0.04) and progression-free survival (hazard ratio 6.03, p = 0.007).CONCLUSIONS: This study indicates that malnutrition especially in overweight patients negatively influences survival outcomes of trimodality treatment for stage III NSCLC.

U2 - 10.1097/JTO.0b013e3182208e90

DO - 10.1097/JTO.0b013e3182208e90

M3 - Article

VL - 6

SP - 1563

EP - 1568

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

IS - 9

ER -