title: Association Between Multi-frequency Phase Angle and Survival in Patients With Advanced Cancer.
abstract: The ability to predict survival accurately has implications in clinical decision making.
  
  
  
  We determined the association of phase angle obtained from multi-frequency bioelectric impedance analysis with overall survival in patients with advanced cancer.
  
  
  
  We included consecutive patients with advanced cancer who had an outpatient palliative care consultation. Multi-frequency bioelectric impedance analysis assessed phase angle at three different frequencies (5/50/250 kHz) on each hemibody (right/left). Survival analysis was conducted using the Kaplan-Meier method, log-rank test, and multivariate Cox regression analysis.
  
  
  
  Among 366 patients, the median overall survival was 250 days (95% confidence interval 191-303 days). The mean phase angle for 5, 50, and 250 kHz were 2.2°, 4.4°, and 4.2° on the right and 2.0°, 4.2° and 4.1° on the left, respectively. For all six phase angles, a lower value was significantly associated with a poorer overall survival (P < 0.001). After adjusting for cancer type, performance status, weight loss, and inflammatory markers, phase angle remained independently associated with overall survival (hazard ratio 0.85 per degree increase, 95% confidence interval 0.72-0.99; P = 0.048).
  
  
  
  Phase angle represents a novel objective prognostic factor in outpatient palliative cancer care setting, regardless of frequency and body sides.
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, USA. Electronic address: dhui@mdanderson.org.
authors.forename: David
authors.initials: D
authors.lastname: Hui
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, USA.
authors.forename: Rony
authors.initials: R
authors.lastname: Dev
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Pimental
authors.affiliation: Department of Biostatistics, MD Anderson Cancer Center, Houston, USA.
authors.forename: Minjeong
authors.initials: M
authors.lastname: Park
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Cerana
authors.affiliation: Department of Biostatistics, MD Anderson Cancer Center, Houston, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology; D017097:Electric Impedance; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
keywords: Electric impedance; forecasting; neoplasms; palliative care; prognosis; survival