TY - JOUR
T1 - The prognosis of incurable cachectic cancer patients on home parenteral nutrition
T2 - A multi-centre observational study with prospective follow-up of 414 patients
AU - Bozzetti, F.
AU - Santarpia, L.
AU - Pironi, L.
AU - Thul, P.
AU - Klek, S.
AU - Gavazzi, C.
AU - Tinivella, M.
AU - Joly, F.
AU - Jonkers, C.
AU - Baxter, J.
AU - Gramlich, L.
AU - Chicharro, L.
AU - Staun, M.
AU - Van Gossum, A.
AU - Lo Vullo, S.
AU - Mariani, L.
PY - 2014
Y1 - 2014
N2 - 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. Patients and methods: We studied prospectively 414 incurable cachectic (sub)obstructed cancer patients receiving HPN and analysed the association between patient or clinical characteristics and surviving status. Results: 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. Conclusions: 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.
AB - 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. Patients and methods: We studied prospectively 414 incurable cachectic (sub)obstructed cancer patients receiving HPN and analysed the association between patient or clinical characteristics and surviving status. Results: 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. Conclusions: 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.
KW - Cancer cachexia
KW - Home parenteral nutrition
KW - Incurable cancer patient
KW - Malignant obstruction
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U2 - 10.1093/annonc/mdt549
DO - 10.1093/annonc/mdt549
M3 - Article
C2 - 24406425
AN - SCOPUS:84893360986
VL - 25
SP - 487
EP - 493
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 2
M1 - mdt549
ER -