Nutritional status of patients with gynecologic and breast cancer / Estado nutritivo de pacientes con cáncer ginecológico o de mama

Objective: To identify the preoperative nutritional status of women with gynecologic or breast cancer, in correlation with disease site and staging as well as previous treatments. Subjects and methods: A cross-sectional study of 250 women evaluated by Body Mass Index (BMI) and Subjective Global Assessment (SGA). For data analysis, the chisquare test was applied. Results: Breast cancer was the most frequent cancer, predominating in 56.2%. The median age of the patients was 52 years. In about 57% of these women, the tumor was restricted to clinical stages 0, I and II and 77% of the women had not undergone any other oncologic treatment prior to surgery. Subjective Global Assessment detected 76% of nourished women and 24% undernourished women, while Body Mass Index identified 34% of nourished women, 3.6% undernourished women and 62.4% overweight/obese women. A low level of diagnostic agreement between normal nutrition and malnutrition by both methods was observed (63.8%; kappa (95% CI) = 0.0884 (-0.07-0.24). No correlation between nutritional evaluation and previous treatment and disease staging was observed. Concerning anatomic site, it was subjectively observed that women with cancer of the uterine corpus were more malnourished than the rest (p = 0.02). Conclusions: The findings suggest that a more careful evaluation should be employed to identify preoperative nutritional status in women with gynecologic or breast cancer (AU)

Objetivo: Identificar el estado nutritivo preoperatorio de mujeres con cáncer ginecológico o de mama, en correlación con la localización de la enfermedad y su estadificación, así como de tratamientos previos. Sujetos y métodos: Estudio transversal de 250 mujeres evaluadas mediante Índice de masa corporal (IMC) y Valoración global subjetiva (VGS). Se aplicó la prueba de Chi cuadrado para el análisis de los datos. Resultados: el cáncer de mama fue el tipo más frecuente, predominando en el 56,2%. La edad media de las pacientes fue de 52 años. En cerca del 57% de ellas, el tumor estaba limitado a los estadios clínicos 0, I y II, y el 77% de ellas no habían sido sometidas a ningún otro tratamiento oncológico antes de la cirugía. La valoración global subjetiva detectó un 76% de las mujeres bien nutridas y 24% malnutridas, mientras que el Índice de masa corporal identificó un 34% de las mujeres bien nutridas, un 3,6% de ellas malnutridas, y un 62,4% de mujeres con sobrepeso/obesidad. Se observó un nivel bajó de concordancia para nutrición normal y malnutrición entre ambos métodos (63,8%; kappa (IC 95%) = 0,0884 (-0,07-0,24). No se observó ninguna correlación entre la evaluación nutricional y tratamiento previo o estadificación de la enfermedad. Con respecto a la localización anatómica, se observó subjetivamente que las mujeres con cáncer del cuerpo del útero presentaban mayor desnutrición que el resto (p = 0,02). Conclusiones: Los hallazgos sugieren que se debería realizar una evaluación más minuciosa para identificar el estado nutritivo de las mujeres con cáncer ginecológico o de mama (AU)

Nutritional status of patients with gynecologic and breast cancer.

OBJECTIVE: To identify the preoperative nutritional status of women with gynecologic or breast cancer, in correlation with disease site and staging as well as previous treatments. SUBJECTS AND METHODS: A cross-sectional study of 250 women evaluated by Body Mass Index (BMI) and Subjective Global Assessment (SGA). For data analysis, the chi-square test was applied. RESULTS: Breast cancer was the most frequent cancer, predominating in 56.2%. The median age of the patients was 52 years. In about 57% of these women, the tumor was restricted to clinical stages 0, I and II and 77% of the women had not undergone any other oncologic treatment prior to surgery. Subjective Global Assessment detected 76% of nourished women and 24% undernourished women, while Body Mass Index identified 34% of nourished women, 3.6% undernourished women and 62.4% overweight/obese women. A low level of diagnostic agreement between normal nutrition and malnutrition by both methods was observed (63.8%; kappa (95% CI) = 0.0884 (-0.07-0.24). No correlation between nutritional evaluation and previous treatment and disease staging was observed. Concerning anatomic site, it was subjectively observed that women with cancer of the uterine corpus were more malnourished than the rest (p = 0.02). CONCLUSIONS: The findings suggest that a more careful evaluation should be employed to identify preoperative nutritional status in women with gynecologic or breast cancer.