Nutritional status, acute phase response and depression in metastatic lung cancer patients: correlations and association prognosis

Support Care Cancer. 2012 Aug;20(8):1823-9. doi: 10.1007/s00520-011-1282-x. Epub 2011 Oct 1.


Background and aim: Cancer cachexia is a metabolic syndrome related with poor outcome. Cytokines play a key role in the pathophysiology of that syndrome. The aim of this study was to investigate the potential correlations between nutritional status, systemic inflammation, and psychological distress in cancer patients. The prognostic significance of the recorded parameters was also assessed.

Patients and methods: Patients with metastatic lung cancer were eligible. Mini Nutritional Assessment (MNA) was used for the evaluation of nutritional status, Glasgow Prognostic Score (GPS) for the estimation of systemic inflammation, and Hospital Anxiety and Depression Scale (HADS) for psychological assessment.

Results: Totally, 122 patients were enrolled (71.3% with NSCLC and 28.7% with SCLC). The following correlations were observed: MNA and GPS (r = 0.289, p = 0.001), MNA and HADS (depression scale) (r = 0.275, p = 0.002), GPS and HADS (depression scale) (r = 0.256, p = 0.004), and GPS and HADS (anxiety scale) (r =0.194, p =0.033). In univariate analysis, GPS (p = 0.002) and MNA (p = 0.010) emerged as significant predictors of survival. In multivariate analysis, both MNA (p = 0.032) and GPS (p = 0.020) retained their importance.

Conclusions: This study highlights the associations between nutritional status, systemic inflammation, and psychological distress, supporting their common underlying pathophysiological mechanisms and further suggesting the necessity of a holistic anti-cachectic approach.

MeSH terms

  • Acute-Phase Reaction / etiology*
  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism
  • Depression / etiology*
  • Female
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / psychology*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Nutritional Status*
  • Prognosis
  • Risk Assessment
  • Serum Albumin / analysis
  • Surveys and Questionnaires


  • Serum Albumin
  • C-Reactive Protein