title: [Quality of life in gastrointestinal cancer: what is the impact of nutrition?].
abstract: BACKGROUND
  Nutrition and Quality of Life (QoL) are key issues.
  
  
  OBJECTIVE
  1) to evaluate Quality of Life (QoL), nutritional status and dietary intake, taking into account the stage of disease and therapeutic interventions, 2) to determine potential inter-relations, 3) to quantify the relative contributions of cancer/nutrition/treatments on QoL.
  
  
  METHODS
  In 184 oesophagus, stomach and colon/rectum cancer patients, the following were evaluated: QoL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire), nutritional status (% weight loss over the previous 6 months), usual diet (diet history), current diet (24 hr recall) and a range of clinical variables.
  
  
  RESULTS
  Stage III/IV patients showed a significant reduction from their usual energy/protein intake (p=0.001), worse in oesophagus (p=0.02), while current intakes were lower than in stage I/II patients (p=0.0002). Weight loss was greater in stage III/IV (p=0.001). Different diagnoses and cancer stages presented different patterns of QoL function scales (p=0,03), significantly and independently associated with nutritional factors (p=0,05). Patients in stage III/IV had increased symptomatology (p=0,003); symptom scales and single items were strongly associated with stage III/IV (p=0,04). Patients with stomach cancer presented the worst global QoL not significantly different from oesophagus, vs colon/rectum, p=0,02.
  
  
  CONCLUSIONS
  In oesophageal, stomach and colon/rectum cancer, nutritional deterioration depends of diet intake, the latter is mainly determined by cancer location and stage. Patients' QoL was determined by cancer or nutrition-related factors with distinct relative weights. Due to this multidimensional construct, in which nutrition plays a major role, nutritional therapy must be integrated in early stages of the overall treatment.
authors.affiliation: Unidade de Nutrição e Metabolismo, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Ravasco
authors.forename: Isabel
authors.initials: I
authors.lastname: Monteiro-Grillo
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques Vidal
authors.forename: Maria Ermelinda
authors.initials: ME
authors.lastname: Camilo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011788:Quality of Life