Handgrip Strength, Overhydration and Nutritional Status as a Predictors of Gastrointestinal Toxicity in Cervical Cancer Patients. A Prospective Study

Abstract

Background: Antineoplastic treatments produce adverse events (AE) such as gastrointestinal toxicity. These AE can reduce nutritional intake and promote weight and muscle mass loss. Objective: To determine if body composition, nutritional status, or muscle function predicts gastrointestinal toxicity during chemotherapy in cervical cancer (CC) patients. Methods: Women with CC were studied. Nutritional status was evaluated according to PG-SGA, and body composition was measured with bioimpedance. Toxicity was graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE). Results: A total of 207 women, 81 with toxicity and 126 without toxicity groups, were studied. Patients in the toxicity group had less handgrip strength (17.7 ± 5.0 vs. 20.3 ± 5.0 p = 0.0004); phase angle (5.2 ± 1.1 vs. 5.9 ± 1.0, p = 0.0065); higher prevalence of sarcopenia (35.9% vs. 20.6%, p = 0.016); overhydration (25.9% vs. 6.3% p < 0.001); and PG-SGA C (14.1% vs. 4.0%, p < 0.001) when compared to patients without toxicity. Handgrip strength (HR: 0.93, 95% CI 0.88–0.98, p = 0.028), overhydration (HR: 2.82, 95% CI 1.22–6.51, p = 0.015) and been severely malnourished according to PG-PGA (HR: 3.6, 95%CI 1.46–9.2, p < 0.001) were associated with the risk to present gastrointestinal toxicity. Conclusion: handgrip strength, overhydration, and severe malnutrition are independent risk factors to the presence of gastrointestinal toxicity in CC patients

Disclosure Statement

The authors declare no conflict of interest

Author Contributions

Conception and design: LFC, LCM and LCP. Collection and assembly of data: RJL, MGG, TGC and APS. Data analysis and interpretation: LFC, LCM and DGI. Manuscript writing: LFC, LCM and LCP. Final approval of manuscript: LFC, LCP, LCM, TGC, RJL DGI, APS, MGG.

Ethics Approval and Consent to Participate

Ethics approval and consent to participate all patients were given a written description of the study and completed an informed consent. Full anonymity of questionnaire information was guaranteed, as per the consent letter. The ethical review board in approved this project (017/003/ICI) (CEI/1125/17).

Additional information

Funding

Flores-Cisneros Laura is supported by a CONACYT Ph. D. (CVU number 707051).