Nutrition and Cancer-An International Journal最新文献

Sarcopenic obesity is a condition in which the coexistence of sarcopenia and obesity may have unfavorable prognostic implications in cancer. This meta-analysis aims to evaluate the effects of sarcopenic obesity on postoperative outcomes in patients undergoing colorectal cancer surgery. A systematic literature search was conducted in the Scopus, PubMed, and Web of Science databases for articles up to February 8, 2024. The primary outcomes were overall and major complications and overall survival. A random- or fixed-effects model was used in each case based on heterogeneity, and both subgroup and sensitivity analyses were performed. Twenty studies with 11,264 patients were included. The prevalence of sarcopenic obesity was 14.5%. Sarcopenic obesity was found to be a risk factor for overall complications [pooled OR: 1.69 (95% CI: 1.26-2.26); p < 0.001] and major complications [pooled OR: 1.64 (95% CI: 1.06-2.55); p = 0.028]. The effect on overall survival was not significant [pooled HR: 1.24 (95% CI: 0.98-1.56); p = 0.076], but significance varied in some subgroups. Furthermore, sarcopenic obesity was associated with an increased risk of 30-day mortality, but not with prolonged hospitalization. In conclusion, sarcopenic obesity is associated with unfavorable outcomes after colorectal cancer surgery; therefore, it may be useful to include a diagnosis of sarcopenic obesity when formulating the disease prognosis.

This study explored the effect of symptom-based individualized nutritional intervention on chemotherapy tolerance and quality of life (QOL) in patients with colorectal cancer (CRC) undergoing postoperative chemotherapy. Postoperative patients with CRC (n = 88) were randomly assigned to the control group (CG, n = 45) and intervention group (IG, n = 43) receiving conventional diet counseling and symptom-based individualized nutritional intervention, respectively, and chemotherapy tolerance, adverse effects, and QOL were compared. Participants in the IG exhibited better nutritional status at the last chemotherapy cycle, with lower Nutrition Risk Screening 2002 (2.37 ± 0.65 vs. 3.78 ± 0.65, p < 0.01) and Patient-Generated Subjective Global Assessment (6.26 ± 0.76 vs. 7.78 ± 0.70, p < 0.01) scores. Compared with CG, relative dose intensity reduction (9.3% vs. 25.89%, p = 0.02), chemotherapy regimen change (25.58% vs. 53.33%, p < 0.01), and chemotherapy delay (13.95% vs. 35.56%, p = 0.019) were lower in the IG. Nausea/vomiting (2.33% vs. 17.78%, p = 0.017), thrombocytopenia (2.33% vs. 28.89%, p < 0.01), and hand-foot syndrome (4.65% vs. 22.22%, p = 0.03) were less frequent in the IG. Participants in the IG had better QOL, with higher physical function scores at cycles 4 (67.91 ± 5.22 vs. 62.22 ± 4.02, p < 0.01) and 8 (72.71 ± 6.31 vs. 57.63 ± 4.75, p < 0.01). Individualized nutritional interventions improved chemotherapy tolerance and QOL and reduced adverse effects in this patient cohort.

Background: Ovarian cancer is a lethal female cancer with a rising incidence that is often diagnosed late due to a lack of symptoms, affecting survival and quality of life. Studies suggest that dietary factors, especially the levels of branched-chain amino acids such as valine, may influence its development. While valine is essential for metabolism, its specific role in ovarian cancer remains unclear, necessitating further research.

Methods: This study aimed to elucidate the causal relationship between valine and OC through a bidirectional Mendelian randomization (MR) approach. Data were sourced from the IEU OpenGWAS project, encompassing genome-wide association statistics for valine (N = 115,048) and OC (Ncase = 1,218, Ncontrol = 198,523) among European participants. Independent genetic variants associated with each phenotype at genome-wide significance were employed as instrumental variables (IVs). The primary analysis utilized the inverse variance weighted (IVW) method for two-sample MR analysis. MR‒Egger regression was applied to adjust for potential pleiotropy, whereas the weighted median method provided robust causal estimates under the assumption of valid IVs. Sensitivity analyses, including leave-one-out (LOO) analysis, heterogeneity tests, and horizontal pleiotropy assessments, were conducted to ensure the robustness of the findings.

Results: The results revealed a significant causal relationship between valine and OC, identifying valine as a risk factor for OC (p = 0.043, 95% CI = 1.00008-1.00491, OR = 1.00249) in the forward MR analysis. Sensitivity analyses confirmed the absence of heterogeneity (Q_p value >0.05) and horizontal pleiotropy (p > 0.05), and LOO analysis validated the stability of the results. Conversely, reverse MR analysis revealed no causal effect of OC on valine levels (p = 0.875, 95% CI = 0.34125-2.51495, OR = 1.08528).

Conclusions: These findings reveal a causal link between high valine levels and an increased OC risk. This research highlights the monitoring of valine levels as a preventive strategy and the significance of valine metabolism in OC. Future studies are needed to investigate the mechanisms and interventions for reducing risk, offering insights for clinical practice and public health initiatives in OC prevention.

Objective: The primary objective of this investigation was to assess the impact of acupuncture intervention and explore the intricacies of acupoint selection as a therapeutic strategy for chemotherapy-induced Anorexia (CIA).

Method: Eight electronic databases were searched to identify relevant studies on the use of acupuncture for the treatment of CIA to conduct a comprehensive meta-analysis. Following this, the Apriori algorithm, correlation analysis, and cluster analysis were performed to identify correlations between the selection of acupoints.

Results: Acupuncture significantly reduced the incidence of anorexia (RR = 0.76, 95%CI: 0.65, 0.90; I²=63%; p = 0.001; n = 503) and anorexia score (SMD=-0.33, 95%CI: -0.53, -0.14; I²=22%; p = 0.0008; n = 419), as well as preserved body mass (MD = 2.70, 95%CI: 1.08, 4.32; I²=0%; p = 0.001; n = 187) and enhanced physical strength (MD = 4.23, 95%CI: 1.90, 6.55; I²=58%; p = 0.0004; n = 377). Moreover, subgroup analysis highlighted its efficacy in managing anorexia associated with non-gastrointestinal tumors and mitigating the severity of cisplatin-induced anorexia. Meanwhile, Zusanli (ST36), Neiguan (PC6), Tianshu (ST25), Zhongwan (RN12), and Qihai (RN6) were identified as crucial acupoints in CIA management.

Conclusion: Acupuncture holds promise as a potential non-pharmacological approach for managing anorexia during cancer chemotherapy. To provide robust evidence of its effectiveness, well-designed Randomized Controlled Trials (RCTs) with larger participant cohorts, and consistent core outcome measures are essential.

Objective: Identifying early predictive indicators of symptomatic hypocalcemia in patients after thyroidectomy with neck lymph node dissection can help to identify high-risk patients, provide timely intervention, and improve prognosis.

Methods: A retrospective analysis of all relevant information was conducted for patients who underwent total thyroidectomy with neck lymph node dissection at our hospital between April 2021 and September 2022. The primary outcome measure was symptomatic hypocalcemia.

Results: Of the 210 patients who underwent total thyroidectomy with l neck lymph node dissection, 76 patients (36%) experienced symptoms of hypocalcemia. The analysis confirmed that the rate of parathyroid hormone (PTH) decline (OR = 238.414, 95%CI: 51.904-1095.114, P = 0.000) was an independent risk factor for symptomatic hypocalcemia after total thyroidectomy with neck lymph node dissection. The ROC curve indicated that a PTH decline cutoff value of 0.7425 was significantly correlated with symptoms of hypocalcemia, with a sensitivity of 89% and specificity of 69%, which could effectively predict symptomatic hypocalcemia.

Conclusion: A PTH decline rate greater than the cutoff value of 0.7425 is a predictive factor for symptomatic hypocalcemia in adults and may be considered as a high-risk patient and actively managed to supplement calcium as soon as possible to ensure patient safety.

Radiotherapy is a common cancer treatment, and concurrent nutritional interventions can maintain nutritional status and improve clinical and supportive care outcomes. However, optimal nutritional interventions during radiotherapy are not firmly established. Herein, we assessed the feasibility, safety, and efficacy of dietary counseling interventions without oral nutrition supplements on health outcomes in adults receiving radiotherapy for cancer in a systematic review. Prospective clinical trials that implemented nutritional counseling interventions during radiotherapy were identified from four databases from inception through December 2023. Feasibility, safety, and efficacy were extracted from 32 articles that described 23 randomized and 4 non-randomized clinical trials. The interventions included individualized nutritional counseling (n = 14 articles), nutritional counseling plus exercise (n = 4), and nutritional counseling focused on increasing or reducing intake of specific nutrients (n = 9). Trials targeted head and neck (n = 12), pelvic cancers (n = 14), and/or breast (n = 5) cancers. Control groups had variable designs and included general nutrition education and intervention as needed. Studies recruited 120 ± 104 participants (range 26-468). Interventions tended to be feasible regarding retention and attendance at sessions, though feasibility metrics varied among different interventions. Most interventions were safe with no studies reporting adverse events attributable to dietary intervention. Individualized dietary counseling interventions tended to lead to between-group differences favoring the intervention group in regard to improved nutritional status, maintenance or attenuation of loss of body mass, improved quality of life, and reduced radiation-induced toxicities. Diets that encouraged/discouraged specific nutrients tended to recruit patients receiving radiation to the pelvic area and resulted in positive or neutral effects on gastrointestinal symptoms. In conclusion, nutritional interventions appear to be feasible, safe, and effective during radiotherapy for various symptom outcomes.

This study investigates the impact of neoadjuvant therapy (NT) on body composition and its correlation with long-term survival and other clinical outcomes in patients with advanced gastric cancer. We utilized Computed Tomography (CT) scans to measure body composition before and after NT, including Subcutaneous Adipose Tissue Index (SATI), Visceral Adipose Tissue Index (VATI), Skeletal Muscle Index (SMI), and Muscle Density (MA). We then analyzed the decrease in body composition in relation to tumor regression, inflammatory markers, nutritional scores, and long-term survival. Our findings reveal a negative correlation between the decrease in SATI and VATI after NT, and both tumor regression and nutritional score. Notably, patients who experienced a significant loss in SATI or VATI post-NT had shorter Recurrence-Free Survival (RFS) and Overall Survival (OS). Additionally, significant loss in SATI and VATI emerged as an independent risk factor for both RFS and OS. In conclusion, our study convincingly demonstrates that in patients with advanced gastric cancer, SATI and VATI decreases after NT and is negatively associated with tumor regression and nutritional score. A significant loss in SATI and VATI is a risk factor for shorter RFS and OS, thereby underscoring the importance of maintaining body composition during NT.

Currently, the combination of atezolizumab and bevacizumab (Atez/Bev) is recommended as the first-line therapy for patients with advanced hepatocellular carcinoma (HCC). However, there is a lack of research on the levels of nutrient elements in advanced HCC patients receiving Atez/Bev treatment. In this study, data from 35 patients with advanced HCC and 37 healthy individuals of similar age and sex were included. The levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase were significantly increased in patients with HCC. These levels returned to the reference range after three rounds of Atez/Bev treatment. Additionally, the levels of blood urea nitrogen and creatinine (Cr) increased after Atez/Bev treatment. In HCC patients, the levels of calcium (Ca), iron (Fe), and copper (Cu) were significantly higher, while the levels of sodium (Na), magnesium (Mg), and zinc (Zn) were significantly lower compared to healthy individuals. These changes were reversed after Atez/Bev treatment. In conclusion, our findings indicate that treatment with Atez/Bev influences the levels of Ca, Fe, Cu, Na, Mg, and Zn in patients with HCC. The alterations in these elements caused by Atez/Bev treatment require mechanistic research in the future.

The aim of the present study was to determine the effectiveness of combined exercise and nutrition interventions on physical function and quality of life (QOL) in patients with acute leukemia or malignant lymphoma (ML) during inpatient chemotherapy. The study was a randomized controlled trial where patients with acute leukemia or ML who were receiving inpatient chemotherapy and exercise therapy were divided into an intervention group (IG) and a control group (CG). Both groups underwent resistance training and aerobic exercise. The patients in the IG were instructed to take nutritional supplements twice a day. Assessment items were muscle strength (handgrip strength and knee extension strength), 6-min walking test, skeletal muscle mass, QOL, nutritional status, and fatigue. Two-way analysis of variance showed a significant interaction for bilateral handgrip strength and knee extension strength. No significant interactions were found for the other items. The results of the present study showed improved muscle strength in the IG compared to the CG, indicating the effectiveness of combined exercise and nutrition interventions during inpatient chemotherapy in patients with acute leukemia or ML.