The Effect of Copd Presence, Quality of Life and Nutritional Status on Short-Term Survival in Patients With Non-Small Cell Lung Cancer

Murat Yıldız; Sema Avcı; Oral Menteş; Meriç Ünver; Deniz Çelik; Pınar Akın Kabalak; Ülkü Yılmaz

doi:10.31067/acusaglik.850937

Research Article

The Effect of Copd Presence, Quality of Life and Nutritional Status on Short-Term Survival in Patients With Non-Small Cell Lung Cancer

Year 2021, Volume: 12 Issue: 3, 596 - 603, 01.07.2021

Murat Yıldız , Sema Avcı Oral Menteş , Meriç Ünver , Deniz Çelik , Pınar Akın Kabalak , Ülkü Yılmaz

https://doi.org/10.31067/acusaglik.850937

Abstract

Objectives: The aim of this study is to evaluate the association of survival with nutritional status, comorbidity and life quality of patients with locally advanced and advanced non-small cell lung cancer (NSCLC) coexisting with chronic obstructive pulmonary disease (COPD).
Patients and methods: This study was performed with 64 patients (6 female, 58 male) diagnosed with locally advanced and advanced NSCLC from March to August 2015. Demographic features of the patients were evaluated with Mini Nutritional Test (MNT), Charlson Comorbidity Index (CCI), Fat Free Mass Index (FFMI), Nutritional risk screening (NRS 2002), European Organization for Research and Treatment of Cancer (EORTC), Quality of Life (QOL) Group (EORTC-QLQ-C30). The association of those scales’ results with survival was analyzed.
Results: Of the patients, 34.4% (n=22) had the diagnosis of COPD. A significant relation between the presence of COPD and survival was not detected. According to NRS 2002, 33% of the patients were under the risk of nutritional deficiency. According to MNT, 18.8% of the patients showed presence of malnutrition. According to CCI, the patients were in low, moderate and high-risk groups respectively 57.8%,37.5% and 4.7%. FFMI average of the survivors and ex ones were 19.74 kg/m2 and 18.10 kg/m2, respectively. After 6 month-follow up, 25% of the patients died. In the univariate analyses, MNT (p=0.000), NRS 2002 (p=0.000) and FFMI (p=0.012) were associated with survival. According to EORTC-QLQ-C30 scale, performance status, functional scale, physical, occupational, social function values and symptom scores were associated with survival.
Conclusion: In the study when nutritional status were evaluated with FFMI and life quality scales, the result was detected to be associated with survival. On the other hand, whether or not the patient was diagnosed with COPD, histological type of the cancer, stage of the disease, metastasis sites and CCI were not detected to be associated with survival.

Keywords

non-small cell lung cancer, chronic obstructive pulmonary disease, survival

References

1.Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011;61(2):69-90.
2. Republic of Turkey. Ministry of Health. Turkey Public Health Institution Turkey Cancer Statistics Report. 2017.
3. Metintaş S. Akciğer Kanseri Epidemiyolojisi. In: Özlü T, Metintaş M, Karadağ M, Kaya A, eds. Solunum Sistemi ve Hastalıkları 1. Baskı. İstanbul Medikal Yayıncılık; 2010:1347-429.
4. Fu XL, Zhu XZ, Shi DR, Xiu ZL, Wang LJ, Zhao S, et al. Study of prognostic predictors for non small cell lung cancer. Lung Cancer 1999; 23:143-52.
5. Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 2007; 25:1824–31.
6. Stanley KE. Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst 1980; 65:25–32.
7. Asmis TR, Ding K, Seymour L, Shepherd FA, Leighl NB, Winton TL, et al. Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group trials. J Clin Oncol 2008; 26: 54-9.
8. Sin DD, Anthonisen NR, Soriano JB, Agusti AG. Mortality in COPD: role of comorbidites. Eur Respir J 2006; 28: 1245-57.
9. Zhang H. Moleculer signaling and genetic pathways of senescence: its role tumorigenesis and aging. J Cell Physiol 2007; 210: 567-74.
10. Wagner H. Rational integration of radiation and chemotheraphy in patients with unresectable stage IIIA or IIIB NSCLC. Result from Lung Cancer Study Group, Eastern Cooperative Oncology Group, and Radiation Theraphy Oncology Group. Chest 1993; 103:35-42.
11. Malhotra D, Thimmulappa R, Navas-Acien A, Sandford A, Elliott M, Singh A, et al. Decline in NRF2-regulated antioxidants in chronic obstructive pulmonary disease lungs due to loss of its positive regulator, DJ-1. Am J Respir Crit Care Med 2008; 178: 592-604.
12. Extermann M, Overcash J, Lyman GH, Parr J, Balducci L. Comorbidity and functional status are independent in older cancer patients. J Clin Oncol 1998; 16:1582-7.
13. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22: 415-21.
14. Cankurtaran ES, Ozalp E, Soygur H, Ozer S, Akbıyık DI, Bottomley A. Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients. Eur J Cancer Care 2008;17: 98-104.
15. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15:116-22.
16. Schols AM, Broekhuizen R, Weling-Scheepers CA, Wouters EF. Body composition and mortality in chronic obstructive pulmonary disease. Am J Clin Nutr 2005; 82: 53-9.
17. Skillrud DM, Offord KP, Miller RD. Higher risk of lung cancer in chronic obstructive pulmonary disease. A prospective, matched, controlled study. Ann Intern Med 1986; 105:503-7.
18. Spiro SG, Porter JC. Lung cancer-Where are we today? Current advances in staging and nonsurgical treatment. Am J Respir Crit Care Med 2002; 166:1166-96.
19. Goksel T, Akkoclu A; Turkish Thoracic Society, Lung and Pleural Malignancies Study Group. Pattern of lung cancer in Turkey 1994-1998. Respiration 2002; 69:207-10.
20. Luketich JD, Burt ME. Does resection of adrenal metastases from non-small cell lung cancer improve survival? Ann Thorac Surg 1996; 62:1614-6.
21. Schuchert MJ, Luketich JD. Solitary sites of metastatic disease in n on-small cell lung cancer. Curr Treat Options Oncol 2003; 4:65-79.
22. Çalıkuşu Z, Sakallı H, Yılmaz B, Mertsoylu H, Akçalı Z, Özyılkan Ö. Evre I V küçük hücreli dışı akciğer kanserli olgularda prognostik faktörlerin incelenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Derg 2011;2(2):88-91.
23. Çilli A, Özdemir T, Özbulak Ö, Yakışan A, Öğüş C. Akciğer kanserli hastalarda KOAH birlikteliği. Solunum 2003; 5: 20-4.
24. Janssen-Heijnen ML, Schipper RM, Razenberg PP, Crommelin MA, Coebergh JW. Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: a population-based study. Lung Cancer 1998; 21:105-13.
25. Kurishima K, Satoh H, Ishikawa H, Yamashita YT, Homma T, Ohtsuka M, et al. Lung cancer patients with chronic obstructive pulmonary disease. Oncol Rep 2001; 8:63-5.
26. Priegnitz C, Galetke W, Treml M, Randerath WJ. Nutritional risk screening 2002 in clinical pneumology. Pneumologie 2014;68(7):478-82.
27. Planas M, Álvarez-Hernández J, León-Sanz M, Celaya-Pérez S, Araujo K, García de Lorenzo A; PREDyCES® researchers. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer 2015;27: 1049-59.
28. Gioulbasanis I, Georgoulias P, Vlachostergios PJ, Baracos V. Mini Nutritional Assessment (MNA) and biochemical markers of cachexia in metastatic lung cancer patients: Interrelations and associations with prognosis. Lung Cancer 2011; 74:516-20.
29. Gioulbasanis I, Baracos VE, Giannousi Z, Xyrafas A, Martin L, Georgoulias V, et al. Baseline nutritional evaluation in metastatic lung cancer patients: Mini Nutritional Assessment versus weight loss history. Ann Oncol 2011;22(4):835-41.
30. Welch HG, Albertsen PC, Nease RF, Bubolz TA, Wasson JH. Estimating treatment benefits for the elderly: the effect of comppeting risks. Ann Intern Med 1996; 124(6):577-84.
31. Frasci G, Lorusso V, Panza N, Comella P, Nicolella G, Bianco A, et al. Gemcitabine plus vinorelbine versus vinorelbine alone in elderly patients with advanced non-small cell lung cancer. J Clin Oncol 2000; 18:2529-36.
32. Birim O, Maat AP, Kappetein AP, van Meerbeek JP, Damhuis RA, Bogers AJ. Validation of the Charlson comorbidity index in patients with operated primary non-small cell lung cancer. Eur J Cardio Thorac Surg 2003; 23:30-4.
33. Bozcuk H, Dalmis B, Samur M, Ozdogan M, Artac M, Savas B. Quality of life in patients with advanced non-small cell lung cancer. Cancer Nurs 2006; 29:104-10.
34. Braun DP, Gupta D, Staren ED. Quality of life assessment as a predictor of survival in non-small cell lung cancer. BMC Cancer 2011; 11:353.
35. Öz A.Akciğer kanserli hastalarda izlem sürecindeki değişikliklerin yaşam kalitesine etkisinin EORTC-C 30 yaşam kalitesi ölçeği ve izlem sonuçlarıyla değerlendirilmesi. Thesis. 2012.

Küçük Hücre Dışı Akciğer Kanseri Olan Hastalarda Koah Varlığı, Hayat Kalitesi ve Beslenme Durumunun Kısa Dönem Sağkalım Üzerinde Etkisi

Year 2021, Volume: 12 Issue: 3, 596 - 603, 01.07.2021

Murat Yıldız , Sema Avcı Oral Menteş , Meriç Ünver , Deniz Çelik , Pınar Akın Kabalak , Ülkü Yılmaz

https://doi.org/10.31067/acusaglik.850937

Abstract

Amaç: Bu çalışmanın amacı, lokal ileri ve ileri evre küçük hücre dışı akciğer kanseri (KHDAK) ve kronik obstrüktif akciğer hastalığı (KOAH) olan hastalarda beslenme durumu, komorbidite ve yaşam kalitesinin sağkalım ile ilişkisini değerlendirmektir.
Hastalar ve yöntem:Bu çalışma Mart-Ağustos 2015 tarihleri arasında KHDAK tanısı alan lokal ileri ve ileri evre olan 64 hasta (6 kadın, 58 erkek) ileyapıldı. Hastalara ait demografik özellikler, Mini Nutrisyonel Test (MNT), Charlson komorbidite indeksi (CCI), Fat Free mass indeks (FFMI), Nutritional risk screening (NRS 2002), European Organization for Research and Treatment of Cancer (EORTC), Quality of Life (QOL) Group (EORTC QLQ-C30) yaşam kalitesi ölçeği değerlendirildi. Bu ölçeklere ait sonuçların sağkalım ile ilişkisi analiz edildi.
Bulgular: Hastaların %34,4’ünde (n=22) KOAH tanısı mevcuttu. KOAH varlığı ile sağkalım arasında anlamlı ilişki saptanmadı(p>0,05).NRS 2002’ye göre hastaların %67’si nutrisyonel açıdan normal,%33’ü beslenme yetersizliği riski altındaydı.MNT’ye göre hastaların%29,7’sinde malnutrisyon riski ve %18,8’inde ise malnutrisyon mevcuttu.CCI’ye göre hastaların %57,8’i düşük, %37,5’i orta ve %4,7’si yüksek risk grubundaydı.Hastaların FFMI ortalaması 19,33kg/m2 idi (sağ kalanlar;19,74 kg/m2, ex;18,10 kg m2). Altıaylık takip sonrasında hastaların %25’i kaybedildi.Tek değişkenli analizlerde MNT(p=0,000*), NRS 2002(p=0,000*) ve FFMI(p=0,012)sağkalım ile ilişkiliydi. EORTC-QLQ-C30 ölçeğine göre genel sağlık durum, fonksiyonel ölçek, fiziksel fonksiyon, uğraş fonksiyonu, sosyal fonksiyon değerleri ve semptom skorları sağkalım ile ilişkili idi.
Sonuç:Çalışmamızda nutrisyonel durum FFMI ve yaşam kalitesi ölçekleri ile değerlendirildiğinde sağkalım ile ilişkili saptandı. Buna karşın hastada, KOAH tanısı olup olmaması, kanserin histolojik tipi, hastalığın evresi, metastaz bölgeleri ve komorbidite indeksi sağkalım ile ilişkili saptanmadı.

Keywords

küçük hücre dışı akciğer kanseri, kronik obstrüktif akciğer hastalığı, sağkalım

References

1.Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011;61(2):69-90.
2. Republic of Turkey. Ministry of Health. Turkey Public Health Institution Turkey Cancer Statistics Report. 2017.
3. Metintaş S. Akciğer Kanseri Epidemiyolojisi. In: Özlü T, Metintaş M, Karadağ M, Kaya A, eds. Solunum Sistemi ve Hastalıkları 1. Baskı. İstanbul Medikal Yayıncılık; 2010:1347-429.
4. Fu XL, Zhu XZ, Shi DR, Xiu ZL, Wang LJ, Zhao S, et al. Study of prognostic predictors for non small cell lung cancer. Lung Cancer 1999; 23:143-52.
5. Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol 2007; 25:1824–31.
6. Stanley KE. Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst 1980; 65:25–32.
7. Asmis TR, Ding K, Seymour L, Shepherd FA, Leighl NB, Winton TL, et al. Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group trials. J Clin Oncol 2008; 26: 54-9.
8. Sin DD, Anthonisen NR, Soriano JB, Agusti AG. Mortality in COPD: role of comorbidites. Eur Respir J 2006; 28: 1245-57.
9. Zhang H. Moleculer signaling and genetic pathways of senescence: its role tumorigenesis and aging. J Cell Physiol 2007; 210: 567-74.
10. Wagner H. Rational integration of radiation and chemotheraphy in patients with unresectable stage IIIA or IIIB NSCLC. Result from Lung Cancer Study Group, Eastern Cooperative Oncology Group, and Radiation Theraphy Oncology Group. Chest 1993; 103:35-42.
11. Malhotra D, Thimmulappa R, Navas-Acien A, Sandford A, Elliott M, Singh A, et al. Decline in NRF2-regulated antioxidants in chronic obstructive pulmonary disease lungs due to loss of its positive regulator, DJ-1. Am J Respir Crit Care Med 2008; 178: 592-604.
12. Extermann M, Overcash J, Lyman GH, Parr J, Balducci L. Comorbidity and functional status are independent in older cancer patients. J Clin Oncol 1998; 16:1582-7.
13. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22: 415-21.
14. Cankurtaran ES, Ozalp E, Soygur H, Ozer S, Akbıyık DI, Bottomley A. Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients. Eur J Cancer Care 2008;17: 98-104.
15. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15:116-22.
16. Schols AM, Broekhuizen R, Weling-Scheepers CA, Wouters EF. Body composition and mortality in chronic obstructive pulmonary disease. Am J Clin Nutr 2005; 82: 53-9.
17. Skillrud DM, Offord KP, Miller RD. Higher risk of lung cancer in chronic obstructive pulmonary disease. A prospective, matched, controlled study. Ann Intern Med 1986; 105:503-7.
18. Spiro SG, Porter JC. Lung cancer-Where are we today? Current advances in staging and nonsurgical treatment. Am J Respir Crit Care Med 2002; 166:1166-96.
19. Goksel T, Akkoclu A; Turkish Thoracic Society, Lung and Pleural Malignancies Study Group. Pattern of lung cancer in Turkey 1994-1998. Respiration 2002; 69:207-10.
20. Luketich JD, Burt ME. Does resection of adrenal metastases from non-small cell lung cancer improve survival? Ann Thorac Surg 1996; 62:1614-6.
21. Schuchert MJ, Luketich JD. Solitary sites of metastatic disease in n on-small cell lung cancer. Curr Treat Options Oncol 2003; 4:65-79.
22. Çalıkuşu Z, Sakallı H, Yılmaz B, Mertsoylu H, Akçalı Z, Özyılkan Ö. Evre I V küçük hücreli dışı akciğer kanserli olgularda prognostik faktörlerin incelenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Derg 2011;2(2):88-91.
23. Çilli A, Özdemir T, Özbulak Ö, Yakışan A, Öğüş C. Akciğer kanserli hastalarda KOAH birlikteliği. Solunum 2003; 5: 20-4.
24. Janssen-Heijnen ML, Schipper RM, Razenberg PP, Crommelin MA, Coebergh JW. Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: a population-based study. Lung Cancer 1998; 21:105-13.
25. Kurishima K, Satoh H, Ishikawa H, Yamashita YT, Homma T, Ohtsuka M, et al. Lung cancer patients with chronic obstructive pulmonary disease. Oncol Rep 2001; 8:63-5.
26. Priegnitz C, Galetke W, Treml M, Randerath WJ. Nutritional risk screening 2002 in clinical pneumology. Pneumologie 2014;68(7):478-82.
27. Planas M, Álvarez-Hernández J, León-Sanz M, Celaya-Pérez S, Araujo K, García de Lorenzo A; PREDyCES® researchers. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer 2015;27: 1049-59.
28. Gioulbasanis I, Georgoulias P, Vlachostergios PJ, Baracos V. Mini Nutritional Assessment (MNA) and biochemical markers of cachexia in metastatic lung cancer patients: Interrelations and associations with prognosis. Lung Cancer 2011; 74:516-20.
29. Gioulbasanis I, Baracos VE, Giannousi Z, Xyrafas A, Martin L, Georgoulias V, et al. Baseline nutritional evaluation in metastatic lung cancer patients: Mini Nutritional Assessment versus weight loss history. Ann Oncol 2011;22(4):835-41.
30. Welch HG, Albertsen PC, Nease RF, Bubolz TA, Wasson JH. Estimating treatment benefits for the elderly: the effect of comppeting risks. Ann Intern Med 1996; 124(6):577-84.
31. Frasci G, Lorusso V, Panza N, Comella P, Nicolella G, Bianco A, et al. Gemcitabine plus vinorelbine versus vinorelbine alone in elderly patients with advanced non-small cell lung cancer. J Clin Oncol 2000; 18:2529-36.
32. Birim O, Maat AP, Kappetein AP, van Meerbeek JP, Damhuis RA, Bogers AJ. Validation of the Charlson comorbidity index in patients with operated primary non-small cell lung cancer. Eur J Cardio Thorac Surg 2003; 23:30-4.
33. Bozcuk H, Dalmis B, Samur M, Ozdogan M, Artac M, Savas B. Quality of life in patients with advanced non-small cell lung cancer. Cancer Nurs 2006; 29:104-10.
34. Braun DP, Gupta D, Staren ED. Quality of life assessment as a predictor of survival in non-small cell lung cancer. BMC Cancer 2011; 11:353.
35. Öz A.Akciğer kanserli hastalarda izlem sürecindeki değişikliklerin yaşam kalitesine etkisinin EORTC-C 30 yaşam kalitesi ölçeği ve izlem sonuçlarıyla değerlendirilmesi. Thesis. 2012.

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Details

Primary Language	English
Subjects	Respiratory Diseases
Journal Section	Research Articles
Authors	Murat Yıldız Sema Avcı Oral Menteş Meriç Ünver Deniz Çelik Pınar Akın Kabalak Ülkü Yılmaz
Publication Date	July 1, 2021
Submission Date	March 26, 2020
Published in Issue	Year 2021Volume: 12 Issue: 3

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EndNote	Yıldız M, Avcı S, Menteş O, Ünver M, Çelik D, Akın Kabalak P, Yılmaz Ü (July 1, 2021) The Effect of Copd Presence, Quality of Life and Nutritional Status on Short-Term Survival in Patients With Non-Small Cell Lung Cancer. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 12 3 596–603.

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