RESUMEN
BACKGROUND: Muscle function and its correlation with body composition and weight loss have not been studied deeply in pancreas and gastrointestinal cancers. This research aims to determine the skeletal muscle function and its relationship with body compartments, significant weight loss, and performance status (ECOG) 0-2 in a population with advanced digestive cancers. METHODS: A cross-sectional study was designed to determine the relationship between muscular function, weight loss, and body composition. Patients with advanced digestive adenocarcinomas were evaluated. Muscle strength was examined by hand grip technique and body composition by bioimpedance analysis. Values of hemoglobin and albumin were measured in plasma. RESULTS: A sample of 81 patients was included. They had adenocarcinoma of stomach (n = 9), pancreas (n = 28), or colorectum (n = 44). With regard to skeletal muscle function, sub-maximal strength increased when percentage of weight loss decreased (p = 0.002) or when any of the following variables increased: skeletal muscle (p < 0.001), waist-hip ratio (p < 0.001), body surface area (p < 0.001), and body mass index (p = 0.001). According to multivariate analysis of these variables, only percentage of weight loss and skeletal muscle remained statistically significant. Endurance had no correlation with any of the variables. Higher weight loss was found in tumors of the upper tract (stomach and pancreas) in comparison with those of the lower tract (colorectal) (p = 0.005). CONCLUSIONS: In advanced digestive cancer, sub-maximal strength correlated inversely with weight loss and directly with skeletal muscle such as in lung and head and neck cancers. On the other hand, endurance had no correlation with any of the variables considered.
Asunto(s)
Adenocarcinoma/fisiopatología , Composición Corporal/fisiología , Neoplasias Gastrointestinales/fisiopatología , Músculo Esquelético/fisiología , Neoplasias Pancreáticas/fisiopatología , Pérdida de Peso , Adenocarcinoma/metabolismo , Adenocarcinoma/patología , Anciano , Índice de Masa Corporal , Estudios Transversales , Progresión de la Enfermedad , Femenino , Neoplasias Gastrointestinales/metabolismo , Neoplasias Gastrointestinales/patología , Fuerza de la Mano/fisiología , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular/fisiología , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologíaRESUMEN
El tratamiento oncológico con radio y quimioterapia (RT/QT) en pacientes (ptes.) con cáncer de esófago exige, para su adecuada implementación, un soporte nutricional intensivo. Objetivos: Analizar la factibilidad y las complicaciones del uso de la gastrostomía percutánea (GPC) para el apoyo nutricional en ptes. con cáncer de esófago antes del inicio del tratamiento curativo/paliativo con un esquema ambulatorio de RT/QT (6,300 cGy + 5-fluorouracilo + leucovorina cálcica + cisplatino; Intergrupo Argentino para el Tratamiento de los Tumores Gastrointestinales-IATTGI-). Material y métodos: Se evaluaron retrospectivamente las historias clínicas de 31 ptes. con cáncer de esófago, tratados entre mayo de 2001 y abril de 2003 en quienes se colocó una GPC. Todos los ptes. tenían diagnóstico histológico de cáncer de esófago; sexo M/F: 21/10, edad promedio de 65 años (r:38-90). Disfagia, grado II...