ABSTRACT
Abstract Objective: To evaluate the impact of preoperative body composition in patients with renal cell carcinoma (RCC) undergoing surgical treatment. Materials and Methods: This was a retrospective study of 52 patients with RCC undergoing total or partial nephrectomy. Body composition assessment was performed using the body mass index, together with computed tomography analysis at the level of the third lumbar vertebra to measure the area of visceral adipose tissue, as well as the area and density of skeletal muscle mass. Results: Malnutrition, obesity and inadequate skeletal muscle gauge (SMG) were associated with higher hospital length of stay (p = 0.028, p = 0.02 and p = 0.012, respectively). Although the rates of postoperative symptoms and readmissions were low, survival was better among the patients with an adequate SMG than among those with an inadequate SMG (p = 0.003). Conclusion: Among patients with RCC undergoing surgical treatment, preoperative body composition does not seem to be associated with the rates of perioperative complications, although an inadequate SMG seems to be associated with worse overall survival.
Resumo Objetivo Avaliar o impacto da composição corporal pré-operatória em pacientes portadores de carcinoma de células renais (CCR) submetidos a tratamento cirúrgico. Materiais e Métodos: Foi realizado estudo retrospectivo de 52 pacientes portadores de CCR submetidos a tratamento cirúrgico. A avaliação da composição corporal foi realizada por meio do índice de massa corporal e análise da L3 obtida pela tomografia computadorizada para mensurar a área do tecido adiposo visceral, área e densidade da massa muscular esquelética. Resultados: Os pacientes desnutridos, obesos e que apresentaram produto muscular esquelético (PME) inadequado permaneceram mais tempo internados (p = 0,028, p = 0,02 e p = 0,012, respectivamente). As taxas de sintomas e reinternações no pósoperatório foram baixas em toda a amostra, no entanto, observou-se que pacientes com PME inadequado apresentaram uma pior sobrevida em relação aos pacientes com PME adequado (p = 0,003). Conclusão: A análise da composição corporal pré-operatória não mostrou associação com as taxas de complicações periope-ratórias em pacientes portadores de CCR submetidos a nefrectomia total ou parcial, no entanto, a inadequação do PME está associada a uma pior sobrevida.
ABSTRACT
SUMMARY OBJECTIVE: Colorectal cancer is the third most diagnosed malignant neoplasm in the world and the fourth leading cause of cancer mortality. The loss of muscle mass in oncological patients is the main aspect of cancer-related malnutrition. Associations between sarcopenia and poor outcomes, such as high postoperative mortality, chemotherapy toxicity, and reduced survival, have been recently described. The aim of this study was to prospectively assess the prevalence of preoperative sarcopenia in patients with colorectal cancer using validated methods to evaluate muscle strength, muscle mass, and physical performance. METHODOLOGY: This study included patients with colorectal cancer undergoing oncological staging at a Cancer Center in Brazil from May 2019 to March 2020 who had images from abdominal computed tomography available for analysis of body composition. The muscle strength test, physical performance, referred fatigue, and clinical and nutritional data were evaluated. RESULTS: A total of 31 patients were included, and most were diagnosed with colon cancer (77.4%) and clinical stage II in 41.9% of cases. The prevalence of probable sarcopenia was 22.6%; of these patients, sarcopenia was confirmed in 19.4%, and ultimately, 9.7% of the sample was classified as severe sarcopenia. We did not find a significant association between the presence of sarcopenia in our sample and age, sex, tumor staging, nutritional characteristics, referred patient fatigue, or postoperative complications. CONCLUSION: Considering the criteria established by the EWGSOP, the prevalence of preoperative sarcopenia in colorectal cancer patients was 19.4%.
ABSTRACT
Introduction: Tumor resection, chemotherapy and / or radiotherapy are used in the treatment of head and neck neoplasms, and these therapies trigger side effects that interfere with the patient's nutritional status. Nutritional intervention makes it possible to recover nutritional status and contributes to reduce treatment morbidity. Objective: To verify the evolution of the nutritional status of patients with head and neck cancer who followed the treatment and attended the nutrition clinic. Methods: Nutritional status was evaluated based on data collection and weight, height, percentage of weight loss, body mass index, arm circumference, triceps skinfold, nutritional muscular area and nutritional intervention. Results: When comparing the nutritional status of the patients at the beginning and at the final moment of follow-up, we did not observe a statistically significant difference (p=0.261); however, moderate / intense weight loss was observed in 23.6% (n=17) at the end of treatment. When assessing adherence to targeted nutritional therapy and weight loss, it was observed that of the 48 (66.7%) patients who adhered fully to the guidelines, 39 (81.3%) had no significant weight loss (p=0.091). Conclusion: Although the study did not indicate a statistically significant difference in relation to the nutritional status of the patients, 81.3% of those who adhered to the nutritional guidelines did not have significant weight loss corroborating with the results presented in the studies that suggest that individualized nutritional monitoring during radiotherapy and / or radiotherapy concomitant with chemotherapy helps maintain nutritional status.
Introdução: A ressecção tumoral, a quimioterapia e/ou radioterapia são utilizadas no tratamento de neoplasias de cabeça e pescoço, e essas terapias desencadeiam efeitos colaterais que interferem no estado nutricional do paciente. A intervenção nutricional possibilita a recuperação do estado nutricional e contribui para reduzir a morbidade do tratamento. Objetivo: Verificar a evolução do estado nutricional de pacientes com câncer de cabeça e pescoço que acompanharam o tratamento e compareceram à clínica de nutrição. Método: O estado nutricional foi avaliado com base na coleta de dados e peso, altura, percentual de perda de peso, índice de massa corporal, circunferência do braço, prega cutânea tricipital, área muscular nutricional e intervenção nutricional. Resultados: Ao comparar o estado nutricional dos pacientes no início e no momento final do acompanhamento, não observamos diferença estatisticamente significante (p=0,261); no entanto, perda de peso moderada/intensa foi observada em 23,6% (n=17) no final do tratamento. Ao avaliar a adesão à terapia nutricional direcionada e à perda de peso, observou-se que, dos 48 (66,7%) pacientes que aderiram plenamente às orientações, 39 (81,3%) não apresentaram perda de peso significativa (p=0,091). Conclusão: Apesar de o estudo não indicar diferença estatisticamente significante em relação ao estado nutricional dos pacientes, 81,3% daqueles que aderiram às diretrizes nutricionais não apresentaram perda de peso significativa, corroborando com os resultados apresentados em estudos, que sugerem que a monitorização nutricional individualizada durante a radioterapia e/ou radioterapia concomitante à quimioterapia ajuda a manter o estado nutricional.