Association Between Multi-frequency Phase Angle and Survival in Patients With Advanced Cancer

J Pain Symptom Manage. 2017 Mar;53(3):571-577. doi: 10.1016/j.jpainsymman.2016.09.016. Epub 2016 Dec 29.


Context: The ability to predict survival accurately has implications in clinical decision making.

Objectives: We determined the association of phase angle obtained from multi-frequency bioelectric impedance analysis with overall survival in patients with advanced cancer.

Methods: We included consecutive patients with advanced cancer who had an outpatient palliative care consultation. Multi-frequency bioelectric impedance analysis assessed phase angle at three different frequencies (5/50/250 kHz) on each hemibody (right/left). Survival analysis was conducted using the Kaplan-Meier method, log-rank test, and multivariate Cox regression analysis.

Results: Among 366 patients, the median overall survival was 250 days (95% confidence interval 191-303 days). The mean phase angle for 5, 50, and 250 kHz were 2.2°, 4.4°, and 4.2° on the right and 2.0°, 4.2° and 4.1° on the left, respectively. For all six phase angles, a lower value was significantly associated with a poorer overall survival (P < 0.001). After adjusting for cancer type, performance status, weight loss, and inflammatory markers, phase angle remained independently associated with overall survival (hazard ratio 0.85 per degree increase, 95% confidence interval 0.72-0.99; P = 0.048).

Conclusion: Phase angle represents a novel objective prognostic factor in outpatient palliative cancer care setting, regardless of frequency and body sides.

Keywords: Electric impedance; forecasting; neoplasms; palliative care; prognosis; survival.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Composition / physiology
  • Electric Impedance*
  • Electrodiagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / diagnosis*
  • Neoplasms / mortality*
  • Neoplasms / physiopathology
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Young Adult