Background: The prevalence of hepatocellular carcinoma is high among Chinese populations.
Hepatocellular carcinoma often affects one's nutritional status and quality of life. Monitoring the nutritional status is important in liver cancer patients.
Objective: The objective of this study was to assess the nutritional status and quality of life of patients with hepatocellular carcinoma and to analyze the factors that can impact the nutritional status.
Methods: Using patients at the department of radiation oncology of a teaching hospital in Central Taiwan as a convenient sample, 171 patients with hepatocellular carcinoma agreed to participate in the study.
Each subject was interviewed for eliciting personal data, health/disease conditions and answers to
questions in MNA (Mini-Nutritional Assessment), CNAQ (Council on Nutrition Appetite Questionnaire), and EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Core-30).
Anthropometric measurements were also carried out. Biochemical data were obtained from their routine measurements conducted at the hospital. Each patient's nutritional status was evaluated with two
modified versions of the MNA. Version I adopted population-specific anthropometric cut-points and Version II further had the BMI question deleted from the scale and adjusted the scoring. The study protocol was approved by the institutional review boards of Asia University.
Results: MNA-TI and MNA-TII graded 2.3 and 1.8% patients malnourished, 50.3 and 48.0% at risk of
malnutrition, and 47.4 and 50.3% normal, respectively. The total scores of the two versions correlated with hemoglobin, serum albumin, C-reactive protein, appetite status, % weight change, liver cirrhosis status (all above, P<0.001); r-GT, blood urea nitrogen, serum creatinine, tumor stages and number of prescribed drugs (all P<0.05). Regression analysis suggested that % body weight change, number of prescribed drugs, calf circumference and mid-arm circumference were the major predictors of nutritional status.
Discussion: Results of the present study show that the MNA is an effective tool in grading the nutritional status of liver cancer patients. Nearly 50% of patients with hepatocellular carcinoma in Taiwan are malnourished or at risk of nutritional deficiency. Routine use of MNA will enable timely detection of emerging nutritional problems and avoid nutritional deficiencies.
