Nutritional status of patients undergoing lung cancer operations

Patients referred for lung cancer operations were reported to be nutritionally depleted. This may be relevant in determining patient outcome after surgical procedures. A study was undertaken to measure a range of nutritional variables including dietary intake of patients referred to a regional cardiothoracic center for curative lung cancer operations.

Anthropometric measurements, grip strength, fat-free mass (FFM), serum protein concentrations, lymphocyte count, creatinine-height index, subjective global assessment, and data on daily intakes of energy, protein, and vitamin C were collected prospectively. Anthropometric indices were also measured in a group of control patients with mild chronic obstructive pulmonary disease.

Sixty patients and 22 control patients were recruited. Weight, skin-fold thickness, and grip strength were not significantly different between patients and control patients, and both groups were similar to the general population. However, 8 patients (13.3%) had a body mass index (BMI) less than 20, and 14 patients (24.1%) had a fat-free mass index less than 15. Serum albumin and transferrin concentrations and lymphocyte count were very rarely depressed but prealbumin and retinol-binding protein levels were below normal in 11.9% and 8.3% of patients, respectively. Thirty percent of patients reported low energy intake, 13% reported a low protein intake, and 61.7% had reduced vitamin C intake.

Severe nutritional depletion was uncommon in patients referred for operations for lung cancer and its frequency may have been overestimated in some previous reports. A low intake of vitamin C was common in our patients but its clinical significance is unclear.