Nutritional Status of Patients with Cancer: A Prospective Cohort Study of 1,588 Hospitalized Patients.

BACKGROUND: We aimed to assess the nutritional status of cancer patients according to site or treatment type. METHODS: We prospectively evaluated the nutritional status of 1,588 patients based on cancer site and treatment type using the Patient-Generated Subjective Global Assessment tool. We also investigated length of stay (LOS), complication rates after surgery and quality of life (QoL). RESULTS: The patients with esophageal, pancreaticobiliary, and lung cancer had higher malnutrition rates than those with stomach, liver, and colon cancer (52.9%, 47.6%, and 42.8% vs. 29.1%, 24.7%, and 15.9%, respectively; P < 0.05). Patients undergoing chemoradiotherapy (CRT) or supportive care had higher malnutrition rates than those undergoing surgery (35.2% or 68.6% vs. 12.3%; P < 0.05). Among patients undergoing surgery, malnourished patients had longer LOS and tended to have more complications than well-nourished patients (P < 0.05 and P = 0.146, respectively). Malnourished patients had also poorer QoL than well-nourished patients (P < 0.05). CONCLUSION: Malnutrition complicated more in patients with esophageal, pancreaticobiliary, or lung cancer than in those with stomach, liver, or colon cancer. Patients undergoing CRT or supportive care are more likely to be malnourished than those undergoing surgery. Malnutrition may increase LOS and impair QoL.

Development and validation of the smart management strategy for health assessment tool-short form (SAT-SF) in cancer survivors.

PURPOSE: The aim of this study was to develop and validate a short form (SF) of the Smart Management Strategy for Health Assessment Tool (SAT) for cancer patients. METHODS: Data for item reduction were derived from cancer patient data (n = 300) previously used to develop the original SAT. We used regression methods to select and score the new SAT-SF. To assess the instrument's reliability and validity, we recruited another 354 cancer patients from the same hospitals who were older than 18 years and accustomed to using the web. All results were compared with that of the long-form SAT (original SAT). RESULTS: The SAT-SF used is the shorter version, a 30-item (from the original 91-item) instrument, to measure cancer patient's health. The 30-item SAT-SF explained 97.7% of total variance of the full 91-item long-form SAT. All SAT-SF subscales demonstrated a high reliability with good internal consistency compared with the original SAT. The total short-form scores of the three SAT sets (SAT-Core, SAT-Preparation, SAT-Implementation) differentiated participant groups according to their stage of goal implementation and percentage of actions taken in the 10 Rules for Highly Effective Health Behavior. We found acceptable correlations between the three SAT-SF sets and the additional assessment tools compared with the original SAT. CONCLUSIONS: The 30-item SAT-SF had a satisfactory internal consistency and validity for cancer patients with minimal loss of information compared with the original SAT.

Factors related with colorectal and stomach cancer screening practice among disease-free lung cancer survivors in Korea.

BACKGROUND: Lung cancer survivors are more likely to develop colorectal and stomach cancer than the general population. However, little is known about the current status of gastrointestinal cancer screening practices and related factors among lung cancer survivors. METHODS: We enrolled 829 disease-free lung cancer survivors ≥40 years of age, who had been treated at two hospitals from 2001 to 2006. The patients completed a questionnaire that included stomach and colorectal cancer screening after lung cancer treatment, as well as other sociodemographic variables. RESULTS: Among lung cancer survivors, correlations with stomach and colorectal screening recommendations were 22.7 and 25.8%, respectively. Of these, 40.7% reported receiving physician advice to screen for second primary cancer (SPC). Those who were recommended for further screening for other cancers were more likely to receive stomach cancer screening [adjusted odds ratios (aOR) = 1.63, 95% confidence interval (CI), 1.16-2.30] and colorectal cancer screening [aOR = 1.37, 95% CI, 0.99-1.90]. Less-educated lung cancer survivors were less likely to have stomach and colorectal cancer screenings. CONCLUSIONS: Lack of a physician's advice for SPC screening and lower educational status had negative impact on the gastrointestinal cancer screening rates of lung cancer survivors.

Prognostic value of quality of life score in disease-free survivors of surgically-treated lung cancer.

BACKGROUND: We aimed to evaluate the prognostic value of quality of life (QOL) for predicting survival among disease-free survivors of surgically-treated lung cancer after the completion of cancer treatment. METHODS: We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Quality of Life Questionnaire Lung Cancer Module (QLQ-LC13), Hospital Anxiety and Depression Scale (HADS), and Posttraumatic Growth Inventory (PTGI) to 809 survivors who were surgically-treated for lung cancer at two hospitals from 2001 through 2006. We gathered mortality data by linkage to the National Statistical Office through December 2011. We used Cox proportional hazard models to compute adjusted hazard ratios (aHRs) and 95 % confidence intervals (CIs) to estimate the relationship between QOL and survival. RESULTS: Analyses of QOL items adjusted for age, sex, stage, body mass index, and physical activity showed that scores for poor physical functioning, dyspnea, anorexia, diarrhea, cough, personal strength, anxiety, and depression were associated with poor survival. With adjustment for the independent indicators of survival, final multiple proportional hazard regression analyses of QOL show that physical functioning (aHR, 2.39; 95 % CI, 1.13-5.07), dyspnea (aHR, 1.56; 95 % CI, 1.01-2.40), personal strength (aHR, 2.36; 95 % CI, 1.31-4.27), and anxiety (aHR, 2.13; 95 % CI, 1.38-3.30) retained their independent prognostic power of survival. CONCLUSION: This study suggests that patient-reported QOL outcomes in disease-free survivors of surgically-treated lung cancer after the completion of active treatment has independent prognostic value for long-term survival.

Employment status and work-related difficulties in lung cancer survivors compared with the general population.

OBJECTIVE: To investigate the employment status of lung cancer survivors and the work-related problems they face. BACKGROUND: Although the number of lung cancer survivors is increasing, little is known about their employment and work-related issues. METHODS: We enrolled 830 lung cancer survivors 12 months after lung cancer curative surgery (median time after diagnosis, 4.11 years) and 1000 volunteers from the general population. All participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30-item and a questionnaire that included items relating to their jobs. We used logistic regression analysis to identify independent predictors of unemployment. RESULTS: The employment rate of lung cancer survivors decreased from 68.6% at the time of diagnosis to 38.8% after treatment, which was significantly lower than the employment rate of the general population (63.5%; adjusted odds ratio = 2.31, 95% confidence interval: 1.66-3.22). The posttreatment unemployment rate was higher for women than for men. Among survivors, employment was inversely associated with older age, household income, number of comorbidities, and poor social functioning. Fatigue (78.6%) was the most common work-related problem reported by survivors. CONCLUSIONS: Lung cancer survivors experienced more difficulties in employment than did the general population. Age, monthly household income, number of comorbidities, and social functioning appear to be important factors influencing employment status. These findings suggest that lung cancer survivors need support to cope with the financial impact of cancer.

Health-related quality of life in disease-free survivors of surgically treated lung cancer compared with the general population.

OBJECTIVE: We compared the health-related quality of life (HRQOL) of disease-free lung cancer survivors with those from the general population. BACKGROUND: Although clinical research usually is focused on how to better identify the lung patients most likely to benefit from surgery in terms of survival, few studies have concentrated specifically on HRQOL in disease-free lung cancer survivors compared with that of the general population. METHODS: We enrolled 830 disease-free cancer survivors (median time since diagnosis, 4.11 years) who had a past diagnosis of lung cancer and treated with curative surgery (stage from 0 to III) at either of 2 hospitals between 2001 and 2006, and 1000 subjects without a history of cancer were selected randomly from a representative sample of general Korean population. Subjects filled out a questionnaire that included the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the lung cancer module. RESULTS: There were no clinically meaningful differences between the disease-free lung cancer survivors and general population in terms of any of the functioning subscales and most of the symptoms. However, survivors exhibited clinically meaningful worse dyspnea and financial problems on the EORTC QLQ-C30 subscales and dyspnea, coughing, and pain in chest wall on the EORTC QLQ-LC13 subscales than the general population. There was no clinically significant difference between the survivor groups according to the survival time. Survivors receiving lung resection, radiotherapy, and chemotherapy had clinically meaningful worse dyspnea than survivors receiving only lung resection. Lung cancer survivors with a respiratory or cardiologic comorbidity showed clinically meaningful worse social functioning, fatigue, dyspnea, and financial problems. CONCLUSIONS: These findings afford useful information clinicians preparing patients for lung cancer treatment by providing them with an understanding of the potential outcomes, and also for potential intervention targeting supportive care needs.