Desnutrición como factor pronóstico en la supervivencia del paciente pediátrico con cáncer en una institución colombiana

Suárez, Gloria; Cano, Gabriel; Rodríguez, Libia

doi:10.1016/S0123-9015(12)70049-5

Información del artículo

Resumen

Bibliografía

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Estadísticas

Resumen

Objetivo

Determinar si la desnutrición es un factor pronóstico en la supervivencia de los niños con cáncer.

Métodos

Se evaluó retrospectivamente una cohorte de 471 pacientes pediátricos con diagnóstico nuevo de cáncer, a los cuales se les determinó mediante Kaplan-Meier la supervivencia global y libre de recaída hasta 60 meses de seguimiento, según el estado nutricional al diagnóstico medido por los puntajes Z para los índices antropométricos peso y talla para la edad. Con el fin de evaluar el efecto del estado nutricional sobre la supervivencia teniendo en cuenta variables demográficas y oncológicas, se realizó el análisis multivariado Regresión de Cox.

Resultados

La supervivencia global a los 12 meses fue menor en los desnutridos clasificados por puntaje Z peso para la edad y talla para la edad. El puntaje Z peso para la edad influyó en la supervivencia independientemente de las otras variables, p=0,027, razón de riesgo ajustado de 3,3, intervalo de confianza 95% 1,1-9,5.

Conclusiones

La desnutrición de acuerdo con el puntaje Z peso para la edad y talla para la edad al ingreso es un factor pronóstico adverso en la supervivencia global en los pacientes pediátricos con cáncer. El efecto de la desnutrición en la supervivencia del paciente oncológico pediátrico aún es controversial.

Palabras clave:

Desnutrición

supervivencia

neoplasias

asistentes de pediatría

Abstract

Objective

To determine if malnutrition is a prognostic factor in the survival of children with cancer.

Methods

A retrospective evaluation was carried out on a cohort of 471 pediatric patients recently diagnosed with cancer; patients' overall survival and relapse free rates up to 60 months follow up was determined by Kaplan-Meier in accordance with nutritional state at diagnosis, measured by anthropometric index Z- score for weight and height according to age. The multivariable Cox regression analysis was used to evaluate the effect of nutritional state on survival in relation to demographic and oncological variables.

Results

Overall survival at 12 months was lower among the malnourished classified by weight and height Z- score according to age. The Z- weight score according to age influenced survival independent of other variables, p=0.027, adjusted risk cause at 3.3, 95% confidence interval: 1.1-9.5.

Conclusions

Malnutrition as classified by Z-weight and height score according to age at admission is an adverse prognostic factor for the overall survival of pediatric cancer patients. The effect of malnutrition on pediatric cancer patients remains controversial.

Key words:

Desnutrition

Survival

Neoplasms

Pediatric Assistans

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