Cachexia Of Digestive System Cancer Patients And Its Impact On Clinical Outcome

Objective To investigate the Cachexia morbidity of hospitalized patients with digestive system cancer and evaluate its impact to the short-term clinical outcome.Methods By analyzing the clinical data of hospitalized patients with digestive system cancer in Zhongshan Hospital Fudan University from January 2012 to December 2013, investigate the Cachexia morbidity and compare the short-term clinical outcome between Cachexia patients and non-Cachectic patients.Results In this study,5118 of patients were eligible, of 3665 male and 1453 female between 23 and 80 years old; The sex ratio was 2.52:1 and the average age was (60±11) years old. The total Cachexia morbidity of hospitalized patients with digestive system cancer was 15.7%(803/5118). The highest Cachexia morbidity was 34.0%(89/173), discovered in Patients with Pancreatic cancer, followed by Gastric cancer and Colorectal cancer. For Cachexia group and non-Cachectic group, overall completion rate of radical resection respectively were 67.1%(539/803) vs.83.5%(3605/4315), with significant difference (P=0.000). Compare to non-Cachectic group, the Cachexia group was associated with longer hospital stay days[(18.8±7.4)d vs. (15.0±6.0)d, P=0.000], slower postoperative recovery of bowel function [(3.4±0.9)d vs. (3.2±0.8)d, P =0.013], longer postoperative time to intake semifluid [(4.4±1.5)d vs (3.9±1.1)d, P=0.002], and more postoperative complications in 28 days after surgery [31.4%(181/576) vs.26.3%(968/3679), P=0.010]. For Cachexia group and non-Cachectic group, the operative blood transfusion rate were 8.9%(51/576) vs.5.8%(212/3679) respectively, and the average amount of blood transfusion of those patients were [700(600-800)]ml vs. [600(300-800)] ml respectively, with significant difference (P<0.05). After surgery,137 cases of Cachexia group (576 cases) transferred to the ICU with the mean ICU days [4.2 (2.0-6.0)] d, and 741 cases of non-Cachectic group (3679 cases) transferred to the ICU with the mean ICU days [3.8 (2.0-4.0)] d, comparison between the two groups, the difference was significant (P<0.05). The reoperation rate [7.5%(43/576) vs.5.0%(184/3679)], ventilator support rate [3.1% (18/576) vs.5%(57/3679)] and mortality [2.4%(14/576) vs.1.1% (40/3679)] of the Cachexia group were all higher than the non-Cachexia group, with significant difference (P<0.05).Conclusions Cachexia was common in hospitalized patients with digestive system cancer, especially Pancreatic Cancer followed by Gastric Cancer and Colorectal Cancer, and Cachexia was associated with unfavorable short-term clinical prognosis.