Bioelectrical impedance phase angle in clinical practice: implications for prognosis in stage IIIB and IV non-small cell lung cancer

A case series of 165 stages IIIB and IV NSCLC patients treated at our center. The Kaplan Meier method was used to calculate survival. Cox proportional hazard models were constructed to evaluate the prognostic effect of phase angle, independent of stage at diagnosis and prior treatment history.93 were males and 72 females. 61 had stage IIIB disease at diagnosis while 104 had stage IV. The median phase angle was 5.3 degrees (range = 2.9 – 8). Patients with phase angle <= 5.3 had a median survival of 7.6 months (95% CI: 4.7 to 9.5; n = 81), while those with > 5.3 had 12.4 months (95% CI: 10.5 to 18.7; n = 84); (p = 0.02). After adjusting for age, stage at diagnosis and prior treatment history we found that every one degree increase in phase angle was associated with a relative risk of 0.79 (95% CI: 0.64 to 0.97, P = 0.02).We found BIA-derived phase angle to be an independent prognostic indicator in patients with stage IIIB and IV NSCLC. Nutritional interventions targeted at improving phase angle could potentially lead to an improved survival in patients with advanced NSCLC.Worldwide, lung cancer is the most common form of cancer, with an incidence of 1.35 million new cases per year, and 1.18 million deaths, with the highest rates in Europe and North America. Non-small cell lung cancer (NSCLC) accounts for about 80% of all lung cancers [1].Malnutrition is a frequent manifestation in patients with advanced NSCLC and is a major contributor to morbidity and mortality [2]. Malnutrition is characterized by changes in cellular membrane integrity and alterations in fluid balance [3]. As a result, measurement of body composition is an important component of overall nutritional evaluation in cancer patients [4-6].Historically, nutritional status has been evaluated by various objective measures, including anthropometric (e.g. weight change, arm muscle circumference, triceps skinfold thickness) and laboratory (serum albumin, transferrin assays and nitrogen balance studies) measure