Original Communication
European Journal of Clinical Nutrition (2005) 59, 35–40. doi:10.1038/sj.ejcn.1602029 Published online 14 July 2004
Prognostic significance of Subjective Global Assessment (SGA) in advanced colorectal cancer
Guarantor: D Gupta.
Contributors: DG was the main author of the manuscript, initiated the study, collected, analyzed and interpreted data. PGV supervised the project and assisted in interpretation of results. CAL and JB assisted in writing the manuscript. CGL initiated the study and assisted in writing and interpretation. JFG supervised the project and assisted with the statistical analysis.
D Gupta1, C A Lammersfeld1, P G Vashi1, J Burrows1, C G Lis1 and J F Grutsch1
1Cancer Treatment Centers of America® at Midwestern Regional Medical Center, Zion, IL, USA
Correspondence: D Gupta, Cancer Treatment Centers of America at Midwestern Regional Medical Center, 2610 N Sheridan Road, Zion, IL 60099, USA. E-mail: digant.gupta@mrmc-ctca.com
Received 4 November 2003; Revised 10 May 2004; Accepted 11 June 2004; Published online 14 July 2004.
Abstract
Objective: To evaluate the prognostic significance of Subjective Global Assessment (SGA) in advanced colorectal cancer and create statistically distinct prognostic groups of colorectal cancer patients based on clinical and nutritional variables.
Design: A retrospective clinical epidemiologic study.
Setting: A private tertiary care American Cancer Center.
Subjects: In total, 234 colorectal cancer patients aged 29–82 y treated at Cancer Treatment Centers of America at Midwestern Regional Medical Center between January 1995 and March 2001.
Intervention: SGA Questionnaire. SGA A—well nourished; SGA B—moderately malnourished; and SGA C—severely malnourished. Malnutrition was defined as either SGA B or SGA C.
Results: The prevalence of malnutrition in this patient population, as determined by SGA, was 52% (113/217). The median survival of patients with SGA A was 12.8 months (95% CI; 9.1–16.5), those with SGA B was 8.8 months (95% CI; 6.7–10.9) and those with SGA C was 6 months (95% CI; 3.9–8.1); the difference being statistically significant at P=0.0013. Regression tree analysis identified prior treatment history, lactate dehydrogenase (LDH) and SGA to be important predictors of survival for our patient cohort. Patients with no prior treatment history (newly diagnosed disease), low LDH scores, and SGA A had the best overall survival of 40.4 months (95% CI; 30.45–50.4), whereas patients with prior treatment history (progressive disease), high LDH scores, and SGA B/C had the worst overall survival of 4.5 months (95% CI; 2.22–6.76).
Conclusion: The SGA provides useful prognostic information in patients with advanced colorectal cancer.
Sponsors: Cancer Treatment Centers of America.
Keywords:
advanced colorectal cancer, subjective global assessment, nutritional assessment, prognostic significance, survival
