Resting energy expenditure in patients with non-small cell lung cancer

Resting energy expenditure (REE) was determined in 30 patients with newly detected non-small cell lung cancer. Measured values were compared with the values predicted by the Harris-Benedict (HB) formula. Mean REE was 20% higher than predicted. Sixty percent of the patients (18 patients) had an elevated REE (greater than or equal to 115%) compared with this formula. The prevalence of hypermetabolism in a group of patients with gastric and colorectal cancer was only 13% (13 of 104 patients). When corrected for fat-free mass (FFM), REE was still significantly higher (P less than 0.001) in the lung cancer group compared with the gastric and colorectal cancer group. Whereas weight loss in healthy men leads to an adaptational decrease in energy expenditure (EE), weight loss in the patients with lung cancer was accompanied by an increase in REE. Tumor stage, tumor localization, pulmonary function, or smoking behavior could not explain the observed increase in REE in patients with lung cancer. Therefore, these metabolic alterations appear to be tumor mediated.