Determination of malnutrition and sarcopenia in patients with geriatric gastrointestinal system cancer

Malnutrition is common in cancer due to the effects of both tumor and treatment. The risk of malnutrition increases in gastrointestinal system (GIS) cancer patients because of the location of tumor and additional problems caused by aging. The aim of this study is to evaluate geriatric patients with GIS cancer in terms of nutritional aspects, to determine the sarcopenia status in the light of antropometric data and to determine the changes in these parameters after chemotherapy (CT). The study conducted between March 2015 and January 2016. GIS cancer patients (n=153) at 65 age and over (mean age:70,5±5,6, 44 female, 109 men) who admitted for the treatment at Ege University Tulay Aktas Oncology Center and received CT were evaluated and followed during the study. At the first meeting, malnutrition status was detected by Mini Nutritional Assessment. Anthropometric measurements (height, weight, calf circumference, upper arm circumference) and bioelectrical impedance analysis measurements (fat and muscle mass and, phase angle) were also carried out. Muscle functions of the patients were measured with a hand dynamometer. After receiving CT (min: 4, max: 6 weeks), the patients were checked again for the same parameters and compared with the first data. The patient population consisted of colorectal (51.6%), stomach (26.8%), pancreas (11.8%), liver (7.2%), biliary tract (2%) and esophageal cancer patients (0.7%). It is found that 37,9% of the patients were in malnutrition, 34,6% of the patients were under risk of malnutrition and 27,5% of the patients were in normal malnutrition status at the end of the study. At the first meeting, malnutrition rate was increased in normal malnutrition status patients after receiving CT (p=0,001). The number of patients with the calf circumference <31 was 20 (13.1%) before the CT at the first meeting, however, this number increased to 31 (20.3%) after receiving CT (p = 0.003). Severe sarcopenia was detected in 29 patients (19%), moderate sarcopenia was detected in 88 patients (57.5%) and 39 patients were found to be normal (25.5%). It is found that CT worsened nutritional status and decreased the muscle function and calf circumference in GIS cancer patients who have the highest malnutrition risk among geriatric oncology patients. It is understood that this group patients should be monitored very carefully in terms of nutritional status and it would be appropriate to interfere before malnutrition and sarcopenia development.