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,Malnutrition in Patients With Cancer: Comparison of Perceptions by Patients, Relatives, and PhysiciansResults of the NutriCancer2012 Study,Journal of Parenteral and Enteral Nutrition IF：3.517 Publication: Jan 2017,1,THE MAIN CONTENTS,2,1,第,部分,研究背景及目的,3,Malnutrition increases the risk of treatment toxicity and impairs outcomes of patients with cancer. Early nutrition interventions are recommended in properly identified patients for improving treatment tolerance and patient survival.Underestimation of malnutrition remains a significant issue since early recognition of malnutrition may allow for early optimization of nutrition interventions to support patients during treatment. Patient self-screening for malnutrition has been reported as feasible in cancer, and relatives may also provide external information on nutrition.,4,questions:,Whether patients with cancer and/or their relatives are aware of malnutrition and could improve the efficacy of nutri-tion interventions is unclear. However, the subjective awareness of malnutrition by the patients, their relat-ives, and physicians has not yet been assessed or compared.,5,Objective,To compare the validated definition of malnutrition with the perceptions of nutrition status by patients, relatives, and physicians.,To find out the risk factors of malnutrition.,6,2,第,部分,研究方法及对象,7,研究方法及对象,Methods,The NutriCancer2012 multicentric cross-sectional survey was conducted on 1 predefined day. The survey was conducted in 283 departments of private or public hospitals in 36 cities in France on October 9, 2012,and included 2197 patients. Each included patient had to complete a questionnaire. The att-ending physician on the day of the visit was included, as well as the closest relative, who also received questionnaires to com-plete.,8,研究方法及对象,Inclusion criteria,patients diagnosed with cancer, aged 18 years, and willing to complete a questionnaire. Malnutrition was identified as follows: weight loss 5% within 1 month or 10% within 6 months, a body mass index (BMI) 18.5 kg/m2 in patients aged 70 years or 21 kg/m2 in patients aged 70 years, albu-minemia (when available) 35 g/L in patients aged 70 years.,9,3,第,部分,研究结果,10,11,Malnutrition prevalence and statistical analysis:,Overall, 826 patients were malnourished (39%; 95% confidence interval CI, 3741), with a higher pre-valence in patients with liver and pancreatic cancers,12,Malnutrition was identified in 40%, 40%, and 31% of patients in initial evolution, relapse, or remission, respectively, and 27% of patients with local disease stage.,13,Prevalence of malnutrition was 39%. Physicians overestimated malnutrition (44%), whereas patients and relatives underes-timated it (24% and 25%, respe-ctively, P .001).,14,According to quest-ionnaires, 57% of patients and 61% of relatives reported a lower food intake, m-ainly because of GI symptoms .,15,Nutrition int-erventions were recalled and were m-ore frequent in malnouri-shed patients,16,4,第,部分,讨论及总结,17,This study confirmed the high prevalence of malnutrition (39%) in patients with cancer. The percentage obtained is slightly higher than the 30.9% found in a previous study by Pressoir et al7 and lower than the 43.5% and 52% reported by Nourissat et al8 and Segura et al,9 respectively. One explanation could be the different proportions of pa-tients with GI locations: 32% in our study compared with 17% and 34% in the studies by Pressoir et al7 and Nourissat et al,8 respectively, while in the study by Segura et al,9 the proportion of patients with pancreatic and lung cancers was higher.,18,Patients and relatives underestimated malnutrition while physicians overestimated it, indicating a low awareness of patients and relatives regarding malnutrition in cancer.Further studies are needed to improve the awareness of mal-nutrition in patients and their relatives as well as the efficacy of nutrition interventions.,19,请老师同学指正批评,时间：2017.3.15,Thanks for your attention,20,
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