Agreement between PG-SGA category and fat-free mass in colorectal cancer patients. (October 2018)

• Record Type: Journal Article
• Authors: Ræder, Hanna; Henriksen, Christine; Bøhn, Siv Kjølsrud; O`de Fey Vilbo, Anne-Rikke; Henriksen, Hege Berg; Kværner, Ane Sørlie; Rolid, Katrine; Paur, Ingvild; Smeland, Sigbjørn; Blomhoff, Rune
• Is Part Of: Clinical nutrition ESPEN. Volume 27(2018)
• Page Start: 24
• Page End: 31
• Publication Date: 2018-10
• Subjects: Patient-generated subjective global assessment -- Fat-free mass -- Fat-free mass index -- Colorectal cancer -- Sarcopenia; BIA Bioelectrical impedance analysis -- BMI Body mass index -- CRC Colorectal cancer -- CT Computed tomography -- DXA Dual energy x-ray absorptiometry -- ESPEN European Society for Clinical Nutrition and Metabolism -- EWGSOP European Working Group on Sarcopenia in Older People -- FFM Fat-free mass -- FFMI Fat-free mass index -- ICD International classification of diseases and related health problems -- MRI Magnetic resonance imaging -- PG-SGA Patient-generated subjective global assessment -- RCT Randomized clinical trial -- TNM Tumor node metastasis; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2018.07.005
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background and aims: Low fat-free mass (FFM) is associated with adverse outcomes in colorectal cancer (CRC) patients. Patient-Generated Subjective Global Assessment (PG-SGA) is a widely used tool developed to detect patients with malnutrition or at risk of malnutrition. The aim of this study was to investigate the agreement between PG-SGA category and FFM in patients with non-metastatic CRC. Methods: Ninety-seven patients were included and categorized as well nourished (PG-SGA:A, n = 67) or malnourished (PG-SGA:B, n = 30). No patients were severely malnourished (PG-SGA: C). Bioelectrical impedance analysis (BIA) was used to assess FFM. Low FFM was defined as low fat-free mass index (FFMI) according to cut-off values recently proposed by The European Society for Clinical Nutrition and Metabolism (ESPEN). Results: Twenty-nine percent of the patients were identified with low FFMI. The proportion with low FFMI was significantly higher among patients classified as malnourished by PG-SGA compared to well nourished (p = 0.015). The sensitivity was however low, as the PG-SGA categorization classified only 50.0% of the patients with low FFMI as malnourished (PG-SGA B). Using the PG-SGA scores (cut-off point > 4), the sensitivity increased to 60.7%. Physical examination in the PG-SGA identified only 64.3% of the patients with low FFMI as muscle depleted. Conclusion: Our results indicate a low agreement between PG-SGA category and low FFMI among patients with non-metastatic CRC. In clinical practice, PG-SGA should be supplemented by muscle mass assessments by BIA or other methods in order to detect low FFM in this patient group.