Are gastrointestinal problems, nutritional care, and nutritional care needs associated with quality of life in patients with advanced cancer? Results of the observational eQuiPe study

Savvas Paschos; Nora Lize; Simone Eussen; Annemieke van der Padt-Pruijsten; Marieke van den Beuken-van Everdingen; Hanneke van Laarhoven; Marien den Boer; Alexander de Graeff; Ben van den Borne; Herma Ten Have; Marjolanda Kennis; Sandra Beijer; Natasja J H Raijmakers; Lonneke van de Poll-Franse

doi:10.1007/s00520-023-07646-1

Are gastrointestinal problems, nutritional care, and nutritional care needs associated with quality of life in patients with advanced cancer? Results of the observational eQuiPe study

Support Care Cancer. 2023 Feb 27;31(3):189. doi: 10.1007/s00520-023-07646-1.

Authors

Savvas Paschos¹, Nora Lize¹, Simone Eussen², Annemieke van der Padt-Pruijsten³, Marieke van den Beuken-van Everdingen⁴, Hanneke van Laarhoven⁵, Marien den Boer⁶, Alexander de Graeff⁷, Ben van den Borne⁸, Herma Ten Have⁹, Marjolanda Kennis^{10

11}, Sandra Beijer¹, Natasja J H Raijmakers^{12

13}, Lonneke van de Poll-Franse^{1

14

15}

Affiliations

¹ Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands.
² Department of Epidemiology of the Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM) and Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
³ Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands.
⁴ Center of Expertise Palliative Care, Maastricht University Medical Center, Maastricht, the Netherlands.
⁵ Amsterdam University Medical Centers, Department of Medical Oncology, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands.
⁶ Laurentius Hospital, Roermond, the Netherlands.
⁷ Department of Medical Oncology, UMC Utrecht Medical Center, Utrecht, the Netherlands.
⁸ Department of Pulmonology, Catharina Hospital, Eindhoven, the Netherlands.
⁹ Careyn, Utrecht, the Netherlands.
¹⁰ Institution Verbeeten, Tilburg, the Netherlands.
¹¹ General Practice Klein Vlijmen, Vlijmen, the Netherlands.
¹² Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands. n.raijmakers@iknl.nl.
¹³ Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands. n.raijmakers@iknl.nl.
¹⁴ Netherlands Cancer Institute, Amsterdam, the Netherlands.
¹⁵ CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.

PMID: 36847908
DOI: 10.1007/s00520-023-07646-1

Abstract

Purpose: To assess the association of gastrointestinal problems, received nutritional care, and nutritional care needs with quality of life (QoL) in patients with advanced cancer.

Methods: A cross-sectional analysis within the observational prospective eQuiPe cohort study on experienced quality of care and QoL in patients with advanced cancer was performed. QoL and gastrointestinal problems were measured using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30. Received nutritional care (yes/no) and nutritional care needs (yes/a little bit/no) were measured by two questions. Gastrointestinal problems were categorized as clinically important based on the Giesinger thresholds. Univariable and multivariable linear regression analyses adjusted for age, gender, and treatment were used to analyze the association of gastrointestinal problems, received nutritional care, and nutritional care needs with QoL.

Results: Half of the 1080 patients with advanced cancer had clinically important gastrointestinal problems, 17% experienced nutritional care needs, and 14% received nutritional care. Multivariable analyses revealed that the presence of clinically important gastrointestinal problems (β (95% CI): -13.0 (-15.6; -10.4)), received nutritional care (β (95% CI): -5.1 (-8.5; -1.7)), and nutritional care needs (β (95% CI): -8.7 (-11.9; -5.5)) were associated with a low QoL.

Conclusion: Many patients with advanced cancer experience gastrointestinal problems, while only few patients receive nutritional care. These gastrointestinal problems, nutritional care needs, and nutritional care are associated with lower QoL, probably due to reversed causality or the irreversible nature of these problems in the palliative phase. More research on the relation of nutritional care, gastrointestinal problems, and QoL is needed to optimize nutritional support in end-of-life care.

Keywords: Advanced cancer; Gastrointestinal problems; Nutritional care; Nutritional care needs; Palliative care; Quality of life.

Publication types

Observational Study

MeSH terms

Cohort Studies
Cross-Sectional Studies
Humans
Neoplasms* / therapy
Nutritional Support
Prospective Studies
Quality of Life*