Original article: general thoracicDo patients with nonmetastatic non-small cell lung cancer demonstrate altered resting energy expenditure?
Section snippets
Recruitment of cancer patients and control participants
This study was approved by the Human Investigation Review Committee at Tufts-New England Medical Center, and all research participants provided written informed consent before participation. Lung cancer patients were recruited from the Lung Tumor Evaluation Center at New England Medical Center. Only patients with either a tissue-confirmed diagnosis of NSCLC or a high clinical suspicion for NSCLC were approached for recruitment. All had undergone clinical staging, and surgical staging of the
Results
A total of 24 consecutive cancer patients were recruited. Of these, 6 were excluded for one of the following reasons: benign diagnosis after surgical resection (2), tumor other than NSCLC diagnosed after surgical resection (1), hyperthyroidism (1), fever at the time of REE measurement (1), or inability to be matched to control subjects on the basis of BMI, gender, or age (1). The remaining 18 cancer patients were included in the study.
All 18 of these patients underwent measurement of REE and
Comment
To our knowledge, this study is the first to examine critically the issue of REE in patients with nonmetastatic (stages IA to IIIB) NSCLC. Our results suggest that after adjustment either for LBM, as determined by DEXA, or for BCM, as determined by total-body potassium measurement, patients with nonmetastatic NSCLC are hypermetabolic when compared with matched control subjects. Our results also suggest that the cancer cachexia syndrome is not confined to patients who experience weight loss;
Acknowledgements
This work was supported by grants F32CA69742 (AJ) and M01RR00054-36A1 from the National Institutes of Health and USDA contract 53-3K06-5-10.
References (20)
- et al.
Prognostic effect of weight loss prior to chemotherapy in cancer patients
Am J Med
(1980) - et al.
Resting energy expenditure in lung and colon cancer
Metabolism: Clinical and Experimental
(1988) Revisions of the international system for staging lung cancer
Chest
(1997)- et al.
Intralipid infusion combined with propranolol administration has favorable effects in elderly malnourished cancer patients
Metabolism
(1999) - et al.
Current management of cancer associated anorexia and weight loss
Oncology
(2001) - et al.
Metabolism in patients with small cell lung carcinoma compared with patients with non-small cell lung carcinoma and healthy controls
Thorax
(1997) - et al.
Increased resting energy expenditure and weight loss are related to a systemic inflammatory response in lung cancer patients
J Clin Oncol
(1995) - et al.
Analysis of the energy balance in lung cancer patients
Cancer Res
(1994) - et al.
Effect of different tumor types on resting energy expenditure
Cancer Res
(1991) - et al.
Resting energy expenditure in patients with non-small cell lung cancer
Cancer
(1991)
Cited by (49)
Energy Expenditure in Upper Gastrointestinal Cancers: a Scoping Review
2023, Advances in NutritionAnamorelin for advanced non-small-cell lung cancer with cachexia: Systematic review and meta-analysis
2017, Lung CancerCitation Excerpt :Ghrelin agonist also induce growth hormone (GH) secretion and insulin-like growth factor-1 (IGF-1) [12]. The GH and IGF-1 increase LBM and fat mass not only by stimulating appetite but also by preventing energy consumption. [13–15] It was contrary with corticosteroids and progestational drugs, which only stimulate appetite and total body weight (TBW). [16]
Anamorelin for patients with cancer cachexia: An integrated analysis of two phase 2, randomised, placebo-controlled, double-blind trials
2015, The Lancet OncologyCitation Excerpt :These findings suggest that ghrelin's effects are not entirely mediated through increased appetite and that other mechanisms are involved, such as decreased energy expenditure.12,13 This effect is relevant because patients with cancer have increased energy expenditure that contributes to cachexia.14 Inflammation is thought to play a part in cancer anorexia-cachexia syndrome.
The effect of radical treatment and rehabilitation on muscle mass and strength: A randomized trial in stages I-III lung cancer patients
2014, Lung CancerCitation Excerpt :Muscle mass is an even more accurate predictor of survival than BMI [7–9]. Cancer-related muscle wasting has been attributed to various mechanisms, such as the hypermetabolic status, caused by a direct effect of the tumor-induced secretion of hormones or cytokines [10] on the organism [11] and cancer-related fatigue (CRF) caused by the cancer-treatment and the reduced activity pattern [12]. However, the exact pathophysiological mechanism between muscle wasting, decreased muscle strength and CRF in cancer patients remains poorly understood [13].
Managing nutritional support in thoracic oncology
2013, Revue des Maladies RespiratoiresSFNEP oncology nutrition guidelines: Nutritional, energetic and proteinic needs throughout the cancer treatment process
2012, Nutrition Clinique et Metabolisme