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Home    Εκτίμηση της κατάστασης της θρέψης σε ασθενείς με καρκίνο του πνεύμονα με την εφαρμογή του πρωτοκόλλου Mini Nutritional Assessment (MNA) : συσχέτιση με κλινικοεργαστηριακές παραμέτρους υποθρεψίας-καχεξίας και με την επιβίωση  

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Identifier 000369354
Title Εκτίμηση της κατάστασης της θρέψης σε ασθενείς με καρκίνο του πνεύμονα με την εφαρμογή του πρωτοκόλλου Mini Nutritional Assessment (MNA) : συσχέτιση με κλινικοεργαστηριακές παραμέτρους υποθρεψίας-καχεξίας και με την επιβίωση
Alternative Title Evaluation nutritional status in patients with lung cancer with the MNA protocol: correlation with clinico-laboratory parameters related with malnutrition-cachexia and with survival
Author Γκιουλμπασάνης, Ιωάννης Γ
Thesis advisor Μαυρουδής, Δ.
Reviewer Γεωργούλιας, Βασίλης
Μαργιωρής, Α.
Abstract Cancer cachexia syndrome frequently accompanies lung cancer and is related with increased morbidity and adverse prognosis. The syndrome is characterized by loss of muscle mass with or without loss of fat tissue as a consequence of an underline disease. Cytokines seem to play a major pathophysiologic role as they modify orexiogenic signals, they influence energy balance and they stimulate muscle degradation as well as fat loss. In its early stage, when the syndrome is theoretically reversible, usually it does not provoke clinical suspicion. On the other part of the spectrum, when the syndrome is fully established, any intervention might be not only ineffective but also futile. Sarcopenic obesity is another confounding factor which masks syndrome’s timely diagnosis as muscle loss occurs under a layer of fat. Till now, diagnosis of the syndrome is based solely on the quantification of weight loss. However, and besides the lack of agreement among physicians on the exact percentage of weight loss and the time period in which this should occur, this method of nutritional assessment represents a rather oversimplified approach. On the other hand, an in-depth nutritional evaluation performed by a registered dietitian is time consuming, costly, requires specialized equipment and, thus, could not applied routinely. Screening questionnaires like the Mini Nutritional Assessment (MNA), originally developed for elderly patients with non malignant diseases, have been proposed as a more accurate nutritional assessment. In the present study MNA was validated and compared against the weight loss history in patients with metastatic lung cancer. MNA identifies more patients as candidates for nutritional support and outperforms weight loss in terms of its correlation with clinico-laboratory related with malnutrition, response to antineoplastic therapy and prognosis. Despite the fact that MNA is a geriatric protocol, its prognostic value was also demonstrated in the subgroup of non-elderly patients. Interestingly, according to MNA, more than 50% of the obese patients were at nutritional risk and, thus, they should be referred for nutritional support. In the present study MNA was validated in metastatic lung cancer patients, and based on our results could be used for the nutritional evaluation in this population. Moreover, it is possible to consider MNA as a new standard method against which any proposed nutritional assessment tool could be tested.
Language Greek
Subject Cachexia
Lung cancer
Neoplasms diet therapy
Nutrition Therapy
Nutritional assessment
Weight loss
Απώλεια βάρους
Καρκίνος πνεύμονα
Κατάσταση της θρέψης
Καχεξία
ΜΝΑ
Νεοπλάσματα Διαιτοθεραπεία
Issue date 2011-07-15
Collection   School/Department--School of Medicine--Department of Medicine--Doctoral theses
  Type of Work--Doctoral theses
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