Clinical Nutrition Research

The Korean Society of Clinical Nutrition (한국임상영양학회)
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Pre-treatment Nutritional Risk Assessment by NRS-2002 Predicts Prognosis in Patients With Advanced Biliary Tract Cancer: A Single Center Retrospective Study

  • Se Eung Oh (Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Juong Soon Park (Department of Clinical Nutrition, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Hei-Cheul Jeung (Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine)
  • Received : 2022.04.22
  • Accepted : 2022.07.24
  • Published : 2022.07.31
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Abstract

We investigated the predictors of survival in patients with advanced BTC according to their baseline nutritional status estimated by the Nutritional Risk Screening (NRS)-2002. From September 2006 to July 2017, we reviewed the data of 601 inpatients with BTC. Data on demographic and clinical parameters was collected from electronic medical records, and overall survival (OS) and progression-free survival were analyzed using the Kaplan-Meier method and the stepwise Cox regression analysis. Patients with an NRS-2002 score of ≤ 2, 3, and ≥ 4 were respectively classified as "no risk," "moderate risk," "high risk." Following initial NRS-2002 score, 333 patients (55%) were classified as "no-risk," 109 patients (18%) as "moderate-risk," and 159 patients (27%) as "high-risk." Survival analysis demonstrated significant differences in the median OS: "no-risk": 12.6 months (95% confidence interval [CI], 11.5-13.7); "moderate-risk": 6.1 months (95% CI, 4.3-8.0); and "high-risk": 3.9 months (95% CI, 3.2-4.6) (p < 0.001). NRS-2002 score was an independent factor for OS (hazard ratio [HR], 1.616 for "moderate-risk", 95% CI, 1.288-2.027, p < 0.001; HR, 2.121 for "high-risk", 95% CI, 1.722-2.612, p < 0.001), along with liver metastasis, peritoneal seeding, white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, cholesterol, carcinoembryonic antigen, and carbohydrate antigen 19-9. In conclusion, baseline NRS-2002 is an appropriate method for discriminating those who are already malnourished and who have poor prognosis in advanced BTC patient. Significance of these results merit further validation to be integrated in the routine practice to improve quality of care in BTC patients.

Keywords

Acknowledgement

We would like to thank all the patients with advanced biliary cancer whose data were included in this study.

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