title: Nutritional status affects treatment tolerability and survival in metastatic colorectal cancer patients: results of an AGEO prospective multicenter study.
abstract: BACKGROUND
  The possible impact of malnutrition on the tolerability and efficacy of modern chemotherapy regimens for metastatic colorectal cancer (mCRC) is unclear.
  
  
  METHODS
  In this prospective, cross-sectional, multicenter study, we collected demographic, oncological and nutritional data for all consecutive mCRC patients during a 14-day period in eight hospitals. Nutritional status was assessed with the nutritional risk index (NRI), and patients were classified as severely malnourished when NRI was <83.5; drug-induced toxicities were evaluated using the National Cancer Institute Common Toxicity Criteria (version 3.0). Survival times were calculated from the date of the nutritional assessment.
  
  
  RESULTS
  We enrolled 114 mCRC patients (median age: 65 years, range: 22-92; WHO performance status 0/1/2/3: 21/54/21/4%) of whom 88% had at least 2 metastatic sites and 49% were receiving chemotherapy as first-line treatment. Malnutrition was diagnosed in 65% of the patients and was severe in 19%. Severe malnutrition was associated with more adverse effects following chemotherapy (p = 0.01) and with shorter median overall survival (14.0 vs. 36.2 months in non-/moderately malnourished patients, p = 0.02).
  
  
  CONCLUSIONS
  In mCRC patients, severe malnutrition is associated with greater chemotherapy toxicity and reduced overall survival.
authors.affiliation: Service de gastro-entérologie et d'oncologie digestive, Hôpital Européen Georges Pompidou, Faculté Paris Descartes, France.
authors.forename: Maximilien
authors.initials: M
authors.lastname: Barret
authors.forename: David
authors.initials: D
authors.lastname: Malka
authors.forename: Thomas
authors.initials: T
authors.lastname: Aparicio
authors.forename: Cécile
authors.initials: C
authors.lastname: Dalban
authors.forename: Christophe
authors.initials: C
authors.lastname: Locher
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Sabate
authors.forename: Samy
authors.initials: S
authors.lastname: Louafi
authors.forename: Touraj
authors.initials: T
authors.lastname: Mansourbakht
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.forename: Alain
authors.initials: A
authors.lastname: Attar
authors.forename: Julien
authors.initials: J
authors.lastname: Taieb
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000378:metabolism*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009752:Nutritional Status; D011446:Prospective Studies; D015996:Survival Rate; D055815:Young Adult