title: Outcomes of systematic nutritional assessment and medical nutrition therapy in pancreatic cancer.
abstract: OBJECTIVE
  We investigated the nutritional and survival outcomes of medical nutrition therapy by a registered dietitian, along with support from a dedicated nutrition and metabolic support team in pancreatic cancer patients requiring enteral or parenteral nutrition.
  
  
  METHODS
  Subjective global assessment (SGA) was used to assess nutritional status in 304 pancreatic cancer patients. Using baseline and last SGA, patients were categorized into 3 groups: improved SGA, deteriorated SGA, and unchanged SGA. Kaplan-Meier and Cox regression were used to calculate survival after controlling for relevant confounders.
  
  
  RESULTS
  One-hundred twenty-five (41.1%) patients had their SGA unchanged, 87 (28.6%) patients had "improved SGA," whereas 92 (30.3%) patients had "deteriorated SGA." On univariate survival analysis, the median survival was 7.8, 11.2, and 12.6 months for deteriorated, unchanged, and improved SGA groups, respectively. On multivariate analysis, change in SGA was independently predictive of survival. Patients with deteriorated SGA had 1.5 times (95% confidence interval, 1.1-2.1) greater risk of mortality compared to those with improved SGA.
  
  
  CONCLUSIONS
  The majority of pancreatic cancer patients (70%) in our study either maintained or improved their nutritional status during cancer treatment. Improvement in SGA correlated with a significantly decreased risk of mortality independent of sex, previous treatment history, and evidence of biological anticancer activity.
authors: From the Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, IL.
authors: Pankaj
authors: P
authors: Vashi
authors: Brenten
authors: B
authors: Popiel
authors: Carolyn
authors: C
authors: Lammersfeld
authors: Digant
authors: D
authors: Gupta
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D016009:Chi-Square Distribution; D004750:Enteral Nutrition / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009752:Nutritional Status; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States