Associação da fragilidade e da sarcopenia com a qualidade de vida relacionada à saúde de pacientes com câncer colorretal

• Autor(a) principal: Barbosa, Mariana Vieira
• Data de Publicação: 2019
• Outros Autores: [e-mail]
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/18385
• topic: Colorectal neoplasms; Quality of life; Frailty; Sarcopenia; Neoplasias colorretais; Qualidade de vida; Fragilidade; Sarcopenia; CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA

Cancer and its treatment have a significant impact on patients' health-related quality of life (HRQoL). Despite this, HRQoL as the primary endpoint of cancer frailty or sarcopenia has been poorly investigated, even though it has been negatively influenced by a reduction in functionality. In this sense, it is necessary to understand the real impact of these syndromes in the HRQoL. The aim of this study was to evaluate the association of frailty and sarcopenia with HRQoL of patients with colorectal cancer. A cross-sectional study was performed with patients diagnosed with colorectal cancer (CRC) in the year 2017, attended at Hospital do Câncer I/INCA (HCI/INCA) from march to december 2018. Patients were submitted to an interview, nutritional assessment and application of questionnaires. The frailty phenotype criteria adapted to the Brazilian population were applied. HRQoL was assessed using the EORTC questionnaire QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire). Body composition was evaluated by computed tomography images, performed with a maximum difference of 3.0 months from the date of study participation. Sarcopenia was defined by the European consensus review guidelines for sarcopenia. This project was submitted and approved by the Research Ethics Committee of the Instituto Nacional de Câncer on May 9, 2016 (CAEE 54778216.7.0000.5274). Descriptive analysis of the population and univariate and multivariate linear regression analysis between frailty and HRQoL domains and between sarcopenia and HRQoL domains were performed, considering the 95% confidence interval. A total of 142 patients were included, with a mean of age of 62.7 years (± 11.4). After adjusting for sociodemographic, clinical, and nutritional variables, regression analysis showed that been frail reduced the HRQoL in physical (B=-15, p=0.002), global (B=-12.8, p=0.047) and emotional functions (B=-22.1, p=0.016) and increased symptoms as, fatigue (B=11.5, p=0.047), nausea/vomiting (B=7.8, p<0.001), pain (B=21.1; p=0.009), dyspnea (B=9.4, p=0.049) and loss of appetite (B=13.1, p=0.038). On the other hand, the combined association of sarcopenic and probable sarcopenic contributed to the worsening of HRQoL, with a reduction in the overall health status (B=-15.0, p=0.002), in physical (B=-15.2, p=0.001) and emotional functions (B=-22.6, p=0.013) and increased scores on fatigue (B=13.5, p=0.017), pain (B=18.8, p=0.020), dyspnea (B=10, 8, p=0.021) and loss of appetite (B=11.9, p=0.044). These dimensions were also impacted by the reduction of hand grip strength (HGS) when its association with HRQoL was verified. In conclusion, both frailty and sarcopenia negatively associated the HRQoL of patients with CRC. The HGS was a negatively associated the same HRQoL parameters as the probable sarcopenia/sarcopenia, and could be used as the variable of choice in clinical practice that is associated with HRQoL.