nutrition_oncologie

Retrospective Analysis of the Impact of a Dietitian and the Canadian Nutrition Screening Tool in a Geriatric Oncology Clinic

Tue, 13 May 2025 20:00:00 -0400

Nutrients. 2025 May 6;17(9):1591. doi: 10.3390/nu17091591.

ABSTRACT

INTRODUCTION: Canada's aging population is leading to an increased number of older adults being diagnosed with cancer. This population faces unique challenges, including frailty, comorbidities, polypharmacy, and malnutrition, which can negatively affect treatment outcomes. The role of registered dietitians (RDs) in managing nutrition-related issues in this population is well-documented, but there is limited research on their integration into geriatric oncology clinics. We evaluated the impact of integrating a registered dietitian (RD) into the Older Adult with Cancer Clinic (OACC) at the Princess Margaret Cancer Centre, Toronto, Canada.

MATERIALS AND METHODS: A retrospective chart review was conducted of older adult cancer patients seen at the OACC, comparing outcomes before and after the RD's integration. The focus was on weight characteristics and change, malnutrition screening/identification, and management. The two-item Canadian Nutrition Screening Tool (CNST) was introduced during the RD's integration and was also examined to see its usefulness in identifying malnutrition risk. Chi-squared tests and t-tests were used for data analysis.

RESULTS: The pre-cohort (n = 140) had a mean age of 80.2 years, 48.6% female, and 77.9% vulnerable (Vulnerable Elders Survey (VES-13) ≥ 3). The post-cohort (n = 117) had a mean age of 81.4 years, 59.8% female, and 80.3% vulnerable (VES-13 ≥ 3). Weight change within 3 ± 1 months after the initial OACC consult was similar between pre and post groups with -1.4 kg and -1.2 kg, respectively (p = 0.77). Patients at nutritional risk, as determined by the OACC team, generated significantly more referrals to the RD in the post group (100% vs. 36.4%, p < 0.001). Among patients who had CNST screening and saw the RD, there was a higher rate of high nutrition risk among CNST-positive compared to CNST-negative patients (67.2% versus 44.4%, respectively). After the integration of the RD, a greater number of patients at nutritional risk received nutritional education and referrals to other healthcare professionals (43 versus 1).

CONCLUSIONS: The integration of an RD into the OACC led to improved referral rates, nutritional education, and referrals to other healthcare professionals. Moreover, patients who were CNST positive were more likely to have high nutritional risk.

PMID:40362900 | PMC:PMC12073638 | DOI:10.3390/nu17091591

Polymorphism of the regulatory region of the ITGAM gene (-323g>a) as a novel predictor of a poor nutritional status in head and neck cancer patients subjected to intensity-modulated radiation therapy

Sat, 10 May 2025 04:19:06 -0400

Author Names: Mazurek M.,Mlak R.,Homa-Mlak I.,Powrozek T.,Brzozowska A.,Golebiowski P.,Malecka-Massalska T.

Database Source: Embase Weekly Updates

Journal Title: Journal of Clinical Medicine

Article Title: Polymorphism of the regulatory region of the ITGAM gene (-323g>a) as a novel predictor of a poor nutritional status in head and neck cancer patients subjected to intensity-modulated radiation therapy

Year: 2020

Issue: 12

Volume: 9

Abstract: Background: The most serious disturbance of the nutritional status is neoplastic cachexia. The main factor contributing to the development of cachexia is the ongoing inflammatory process. The gene associated with the development of the inflammatory response is ITGAM. Therefore, the aim of the study was to assess the relationship between a single nucleotide polymorphism (SNP)-323G>A of the ITGAM gene and the occurrence of nutritional disorders in patients undergoing radiotherapy (RT) due to head and neck cancers (HNC). Method(s): The study involved 71 patients with HNC treated with intensity-modulated radiotherapy (IMRT). SNP analysis of the ITGAM gene (-323G>A) was performed using commercial molecular probes and Real-Time PCR. Result(s): The presence of the A allele of the ITGAM gene significantly (over 14-fold) reduced the risk of severe disturbances in nutritional status assessed according to the subjective global assessment (SGA) scale (odds ratio (OR) = 0.07; p = 0.0213). The GG genotype of this gene was associated with an over three-fold higher risk of shortened overall survival (OR = 3.01; p = 0.0376). Conclusion(s): Determination of the SNP (-323G>A) of the ITGAM gene may prove to be a useful marker in the assessment of the risk of nutritional disorders in patients with HNC undergoing RT. Copyright © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

The impact of preoperative immunonutritional status on postoperative complications in ovarian cancer

Sat, 10 May 2025 04:19:06 -0400

Author Names: Liu X.,Li M.,Zhao Y.,Jiao X.,Yu Y.,Li R.,Zeng S.,Chi J.,Ma G.,Huo Y.,Peng Z.,Liu J.,Zhou Q.,Zou D.,Wang L.,Li Q.,Wang J.,Yao S.,Chen Y.,Ma D.,Hu T.,Gao Q.

Database Source: Embase Weekly Updates

Journal Title: Journal of Ovarian Research

Article Title: The impact of preoperative immunonutritional status on postoperative complications in ovarian cancer

Year: 2025

Issue: 1

Volume: 18

Abstract: Background: Preoperative immunonutritional status can influence postoperative complications. Malnutrition in ovarian cancer patients diminishes the body's resilience to abdominal surgery, resulting in inferior surgical outcomes and increased postoperative complications. We aim to investigate the effect of preoperative immunonutritional status, including NLR, PLR, LMR, TCLR, FAR, FLR, SII, PNI and CONUT on postoperative complications in epithelial ovarian cancer (EOC) in a large population. Method(s): A multicenter real-world study included 922 patients with histologically confirmed EOC who received comprehensive staged surgery or debulking surgery at seven tertiary hospitals in China between 2012 and 2023. Logistic regression and Lasso regression analyses were employed to identify variables associated with postoperative complications. A predictive nomogram model was developed based on multivariate modeling. Result(s): The study included a total of 922 patients diagnosed with epithelial ovarian cancer across seven medical centers with 565 (61.3%) patients experiencing postoperative complications. Significant differences were found in the distribution of inflammatory and nutritional risk indicators, including NLR, PLR, LMR, TCLR, FAR, FLR, SII, PNI and CONUT between the two groups (all P < 0.01). A multivariable model identified several predictive factors for postoperative complications: PNI > 46.73 (odds ratio [OR] = 0.49, P < 0.001), FAR > 10.77 (OR = 1.60, P = 0.019), LMR > 3.70 (OR = 0.68, P = 0.044), hydrothorax (OR = 2.60, P = 0.005), laparoscopy (OR = 0.59, P = 0.010 vs. laparotomy), enterectomy (OR = 2.50, P = 0.001). Conclusion(s): Poor immunonutritional status can increase the risk of postoperative complications. These findings suggest that prompt nutritional interventions may reduce the incidence of postoperative complications and improve surgical outcomes. The risk prediction model, including PNI, FAR, LMR, hydrothorax, laparoscopy vs. laparotomy, and enterectomy, might facilitate patient-centered decision-making and risk stratification. Clinical trial registration: The study was registered in the Clinical trial registry: NCT06483399. (https://clinicaltrials.gov/study/NCT06483399) Copyright © The Author(s) 2025.

Validity of a nutrition screening tool for childhood cancer

Sat, 10 May 2025 04:19:06 -0400

Author Names: Kangalgil M.,Meral B.,Murphy Alford A.J.,Erduran E.

Database Source: Embase Weekly Updates

Journal Title: Nutrition in Clinical Practice

Article Title: Validity of a nutrition screening tool for childhood cancer

Year: 2025

Issue: 3

Volume: 40

Abstract: Background: Malnutrition in pediatric oncology patients is a serious clinical condition. There is a need for standardized nutrition screening in pediatric oncology patients, as nutrition screening can offer a simple method to identify children with cancer at risk of malnutrition. This study aimed to determine the validity of a Turkish version of nutrition screening tool for childhood cancer (SCAN) in identifying the risk of malnutrition among children with cancer. Material(s) and Method(s): A cross-sectional study was conducted with 78 children with cancer admitted to the pediatric hematology-oncology unit of a university hospital. In the first stage of this study, SCAN was translated into Turkish, and in the second stage, the validity of SCAN against pediatric Subjective Global Nutritional Assessment (SGNA) and Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) malnutrition criteria were evaluated. Result(s): Patients had a median age of 8.0 years (range, 2-18 years; IQR, 5-14 years), 61.5% were male, and 60.3% were diagnosed with leukemia. According to SCAN, 53.8% had high risk of malnutrition. Validation of SCAN against pediatric SGNA showed that SCAN has a sensitivity of 97.5%, specificity of 94.5%, and accuracy of 96.1%. Conclusion(s): The risk of malnutrition is common in children with cancer. The Turkish version of the SCAN is a simple, quick, and valid tool to determine the risk of malnutrition in children with cancer. Further research is needed to understand the impact of nutrition interventions on clinical outcomes in children at risk for malnutrition based on SCAN. Copyright © 2024 American Society for Parenteral and Enteral Nutrition.

Intake and Nutritional Adequacy in Patients With Cancer Diagnosed With Malignant Bowel Obstruction: A Secondary Analysis of a Randomized Trial

Sat, 10 May 2025 04:19:06 -0400

Author Names: Thomson C.A.,Arnold K.B.,Anderson G.,Sun V.,Secord A.A.,Yung A.,Al-Kasspooles M.,Nfonsam V.N.,Grant M.,Deutsch G.B.,Deneve J.L.,Krouse R.S.

Database Source: Embase Weekly Updates

Journal Title: Journal of the Academy of Nutrition and Dietetics

Article Title: Intake and Nutritional Adequacy in Patients With Cancer Diagnosed With Malignant Bowel Obstruction: A Secondary Analysis of a Randomized Trial

Year: 2025

Issue: 5

Volume: 125

Abstract: BACKGROUND: Malignant bowel obstruction (MBO) is experienced by many with advanced cancer. Patients with MBO cannot eat and may have reduced ability to eat once the acute process has resolved. Sparse data exist to describe oral intake capacity and adequacy of nutrition in patients with MBO. These data are critical to developing effective supportive care nutrition therapy for patients with MBO. OBJECTIVE(S): The aim of this study was to describe the ability to consume food and liquids orally, estimating nutritional adequacy of diet in a sample of patients who received surgical or nonsurgical treatment for MBO. DESIGN: A descriptive secondary data analysis of repeated dietary intake measures from S1316, a pragmatic comparative effectiveness trial of surgical and nonsurgical treatment for MBO. Participant enrollment occurred between 2015 and 2020. Ability to eat was assessed through self-reported telephone survey and intake was estimated using telephone-based 24-hour recalls, applying US Department of Agriculture multipass methodology. PARTICIPANTS/SETTING: The primary trial was conducted within the SWOG Cancer Research Network and included recruitment sites across the United States and Latin America. Eligible participants were diagnosed with, and hospitalized for, MBO. MAIN OUTCOME MEASURES: The main outcomes measures were self- or caregiver-reported ability to eat, as well as overall nutrient intake. STATISTICAL ANALYSIS: Descriptive statistics were used to report patient characteristics, intake, and nutrient adequacy. Nutrient intake was presented by tertiles of gastrointestinal symptom severity and assessed. RESULT(S): Two hundred twenty-one participants were registered; 199 were eligible and included. At week 1, 51% of patients with MBO reported consuming some solid food orally; 34% reported no oral intake; and 13% were on enteral feeding only. For patients alive and responsive to recalls at 13 weeks (n = 57), 82% (n = 47) reported consuming solid food. Compared with recommendations, mean reported intake was inadequate for most nutrients. CONCLUSION(S): Oral intake is reported in more than one-half of patients diagnosed with MBO. Medical nutrition therapy should be tailored to patient's tolerance for eating and with consideration or patient's desire to address nutritional inadequacies. Copyright © 2025 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Do Nutritional and Inflammatory Indices Predict Response in Geriatric Gastric Cancer Patients Treated with Neoadjuvant FLOT Regimen?

Sat, 10 May 2025 04:19:06 -0400

Author Names: Urun Y.Y.,Urun M.

Database Source: Embase Weekly Updates

Journal Title: Cancer Control

Article Title: Do Nutritional and Inflammatory Indices Predict Response in Geriatric Gastric Cancer Patients Treated with Neoadjuvant FLOT Regimen?

Year: 2025

Issue:

Volume: 32

Abstract: Introduction: Docetaxel-based chemotherapy is a standardized neoadjuvant treatment for gastric cancer. There are still no reliable indicators to predict tumor response and prognosis of geriatric patients prior to chemotherapy. The aim of our study was to investigate the value of pretreatment prognostic nutritional index (PNI), serum albumin, total lymphocyte, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in predicting the response to treatment in geriatric gastric cancer patients treated with FLOT (5-Fluorouracil, leucovorin, oxaliplatin, and docetaxel) regimen as neoadjuvant chemotherapy. Method(s): A total of 91 geriatric gastric cancer patients (>=65-year-old) who received a neoadjuvant FLOT regimen were retrospectively analyzed. Pretreatment data, including demographic characteristics, complete blood count, serum albumin level (g/dL), serum tumor markers (CEA and CA19-9), PNI values and other clinicopathological parameters, were collected. Independent sample t-tests and Mann-Whitney U tests were used to analyze quantitative independent data. In the analysis of independent qualitative data, the chi-squared test and Fischer's exact test were used when the chi-squared test conditions were not met. Result(s): The mean age was 69.9 +/- 4. There were 22 patients in the treatment-responsive group and 69 in the treatment-nonresponsive group. Serum albumin levels were significantly higher in the treatment-responsive group. The lymphocyte counts were significantly lower in the treatment-responsive group. Additionally, both disease-free survival and overall survival were significantly extended in patients who responded to treatment. Conclusion(s): We demonstrated that serum albumin and total lymphocyte counts, which are easily accessible blood parameters routinely examined before treatment, may predict the response in geriatric gastric cancer patients receiving neoadjuvant FLOT treatment. However, larger prospective, multicenter studies are required to confirm this relationship. Copyright © The Author(s) 2025.

Nutritional status and related factors in gastric cancer patients after gastrectomy: a cross-sectional study

Sat, 10 May 2025 04:19:06 -0400

Author Names: Muszynski T.,Jedrychowski T.,Witalewska A.,Gawlewicz-Czepiel A.,Polak K.,Spieszny M.,Szczepanik A.

Database Source: Embase Weekly Updates

Journal Title: Polski przeglad chirurgiczny

Article Title: Nutritional status and related factors in gastric cancer patients after gastrectomy: a cross-sectional study

Year: 2024

Issue: 2

Volume: 97

Abstract: Introduction: Gastrectomy due to gastric cancer induces metabolic changes in body composition, directly affecting nutritional status. Aim: The aim of this cross-sectional study was to investigate the nutritional status and related factors in gastric cancer patients after total and subtotal gastrectomy. Materials and methods: A total of 41 patients who underwent gastrectomy due to gastric cancer were included: 20 patients (48.8%) with total gastric resection and 21 patients (51.2%) with subtotal resection were enrolled. The evaluation was performed over a follow-up period ranging from two to four years after surgery during routine oncological monitoring visits. The laboratory tests, bioimpedance parameters, physical activity, and quality of life were evaluated. Results: The only statistically significant differences included BMI, fat percentage, fat mass, and metabolic age in the subtotal gastrectomy group. Overall, post-gastrectomy patients showed suboptimal vitamin D concentration and low physical activity level and were found to be at risk of malnutrition assessed with prealbumin concentration and total lymphocyte count. Discussion: The nutritional status and life quality do not significantly differ between total and subtotal gastric cancer patients. Conclusions: The nutritional status and life quality do not significantly differ between total and subtotal post-gastrectomy patients in long-term follow-up. The analysis of selected parameters suggests that post-gastrectomy patients are at risk of malnutrition. Study significance: The presented study brings better insight into the nutritional status of gastric cancer patients after gastrectomy in long-term follow-up.

Diagnostic performance of GLIM and PG-SGA for malnutrition assessment in adult cancer patients: a systematic review and meta-analysis

Wed, 23 Apr 2025 20:00:00 -0400

BMC Cancer. 2025 Apr 23;25(1):765. doi: 10.1186/s12885-025-13809-6.

ABSTRACT

OBJECTIVE: Consistency between malnutrition defined by Global Leadership Initiative on Malnutrition (GLIM) and Patient-Generated Subjective Global Assessment (PG-SGA) has not been thoroughly elucidated in patients with cancer. The study aimed to compare their consistency, and summarize the impact of malnutrition defined by GLIM on adverse outcomes.

METHOD: PubMed, Embase, Cochrane library and Web of Science databases were searched from inception to May 1, 2024. Initially, the amalgamated sensitivity, specificity and area under curve (AUC) with 95% confidence intervals (CIs) were calculated. Subsequently, hazard ratios (HR) or odd ratios (OR) and 95% CIs for overall survival (OS), all-cause mortality, postoperative complications, disease-free survival (DFS) and recurrence-free survival (RFS) were pooled.

RESULT: Fifty-six studies (55,767 participants) were included. Compared with PG-SGA criteria, the overall sensitivity, specificity and area under curve (AUC) for GLIM was 0.71 (95% CI: 0.63-0.78), 0.80 (95% CI: 0.65-0.90) and 0.79 (95% CI: 0.75-0.83). Subgroup analysis revealed that the diagnostic value in Asian or among patients aged under 60 years were higher than non-Asian or those aged over 60 years. Moreover, GLIM-defined malnutrition was significantly associated with overall survival (OS) [hazard ratios (HR) = 1.57, 95% CI: 1.46-1.67], all-cause mortality (HR = 1.43, 95% CI: 1.29-1.57), postoperative complications [odd ratios (OR) = 1.57, 95% CI: 1.40-1.73], disease-free survival (DFS) (OR = 1.52, 95% CI: 1.36-1.68) and recurrence-free survival (RFS) (OR = 1.41, 95% CI: 1.10-1.72).

CONCLUSION: GLIM criteria exhibit moderate diagnostic accuracy for identifying malnutrition among patients with cancer, when compared to the PG-SGA. This accuracy is pronounced in the Asian and patients under the age of 60. Furthermore, GLIM-defined malnutrition was significantly associated with OS, DFS, RFS, all-cause mortality and postoperative complication risks in patients with cancer.

PMID:40269782 | PMC:PMC12020302 | DOI:10.1186/s12885-025-13809-6

Optimizing Nutritional Care with Machine Learning: Identifying Sarcopenia Risk Through Body Composition Parameters in Cancer Patients—Insights from the NUTritional and Sarcopenia RIsk SCREENing Project (NUTRISCREEN).

Tue, 15 Apr 2025 00:00:00 -0400

Nutrients; 04/15/2025
(AN 184755601); ISSN: 20726643
CINAHL Complete

Nutritional Risk Index (NRI) predicts the clinical outcomes of patients with gastric cancer who received immune checkpoint inhibitors (PD-1/PD-L1)

Thu, 03 Apr 2025 20:00:00 -0400

Medicine (Baltimore). 2025 Jan 3;104(1):e40898. doi: 10.1097/MD.0000000000040898.

ABSTRACT

Numerous studies have consistently indicated a connection between the clinical results of individuals who receive immunotherapy and their nutritional condition. This study aims to evaluate the predictive capacity of the Nutritional Risk Index (NRI) in gastric cancer patients who are undergoing treatment with immune checkpoint inhibitors (ICIs). This study included a total of 146 individuals diagnosed with gastric cancer and received a combination of chemotherapy and immunotherapy using PD-1/PD-L1 inhibitors. The threshold was established by utilizing the receiver operating characteristic (ROC) curve. To analyze the clinical and pathological characteristics of the 2 groups, we performed Chi-square test or Fisher exact test. Univariate and multivariate analyses were performed to assess the factors influencing progression-free survival (PFS) and overall survival (OS) rates. Additionally, we developed nomograms to accurately predict the probability of 1- year and 3-year survival in these patients. According to the threshold, there were 38 (26.0%) patients in the low NRI category and 108 (74.0%) patients in the high NRI category. In the high NRI group, the median survival PFS was 32.50 months, while it was 11.77 months in the low NRI group. Likewise, the average survival OS in the 2 categories was 18.57 months compared to an indefinite duration. Individuals classified in the low NRI category encountered reduced PFS and OS, with a hazard ratio (HR) of 2.015 and 2.093 respectively, along with corresponding P-values of .009 and .006. The analysis of multiple variables showed that the number of platelets and TNM stage were separate factors that predicted both PFS and OS. Additionally, NRI was further recognized as a separate predictive factor for overall survival. The analysis of a specific subgroup revealed that individuals in the low NRI category experienced worse PFS and OS, especially within the group receiving ICIs. The C-index and the respective 95% CI of the nomograms to forecast the likelihood of PFS and OS survival were 0.646 (0.583-0.709) and 0.693 (0.635-0.751). NRI has the capability to forecast the clinical results of individuals who were diagnosed with gastric cancer and have received ICIs. This makes it a feasible biomarker for identifying patients who could benefit from ICIs.

PMID:40184134 | PMC:PMC11709187 | DOI:10.1097/MD.0000000000040898

The Significance of SARC-F Scores in One-Year Mortality of Adults with High Nutritional Risk with Cancer.

Tue, 01 Apr 2025 00:00:00 -0400

Nutrition & Cancer; 04/01/2025
(AN 182326730); ISSN: 01635581
CINAHL Complete

Bridging Gaps in Cancer Care: Utilizing Large Language Models for Accessible Dietary Recommendations.

Tue, 01 Apr 2025 00:00:00 -0400

Nutrients; 04/01/2025
(AN 184440158); ISSN: 20726643
CINAHL Complete

Assessing the Impact of Nutritional Status on the Quality of Life in Head and Neck Cancer Patients—The Need for Comprehensive Digital Tools.

Tue, 01 Apr 2025 00:00:00 -0400

Cancers; 04/01/2025
(AN 184443234); ISSN: 20726694
CINAHL Complete

The Impact of Oral Nutrition Supplementation and Dietary Education on Nutritional Status, Knowledge, Attitudes, and Behaviour in Cancer Patients: A Randomized Clinical Trial

Wed, 26 Mar 2025 20:00:00 -0400

Nutr Cancer. 2025;77(4-5):474-482. doi: 10.1080/01635581.2025.2474260. Epub 2025 Mar 27.

ABSTRACT

Cancer patients often experience significant weight loss due to metabolic changes, increased resting energy expenditure (REE), and poor nutrient intake, particularly exacerbated by treatments like chemotherapy and radiation. This study aimed to determine whether combining Oral Nutrition Supplements (ONS) with dietary education is more effective than dietary education alone in improving nutritional outcomes for cancer patients. An open-label randomized clinical trial at Persahabatan Hospital in Jakarta, Indonesia, involved 108 patients with lung or gynecological cancer, with 87 completing the study. Participants were assigned to receive either dietary education plus ONS (intervention group) or dietary education alone (control group). Results indicated that while both groups improved their nutrition knowledge, the intervention group experienced significant increases in body weight (1.68 ± 3.96 kg) and body mass index (BMI) (0.86 ± 1.96 kg/m²), whereas the control group lost weight. Additionally, the intervention group had a lower rate of anemia (60% vs. 80.9%), though no significant differences were found in albumin levels or inflammation status. These findings suggest that ONS combined with dietary education may help improve weight and BMI in cancer patients, warranting further research to confirm these benefits and assess long-term effects.

PMID:40143706 | DOI:10.1080/01635581.2025.2474260

Nutritional conditions and PFS and OS in cancer immunotherapy: the MOUSEION-010 meta-analysis

Tue, 25 Mar 2025 20:00:00 -0400

Immunotherapy. 2025 Mar;17(4):269-281. doi: 10.1080/1750743X.2025.2483656. Epub 2025 Mar 25.

ABSTRACT

BACKGROUND: The MOUSEION-010 Meta-Analysis assessed the association between nutritional status and clinical outcomes such as Progression Free Survival (PFS) and Overall Survival (OS) among cancer patients treated with immune checkpoint inhibitors (ICIs).

METHODS: Nutritional status was assessed based on the Prognostic Nutrition Index (PNI), Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) indexes. Databases consulted were: Embase, PubMed, Scopus and Web of Science.

RESULTS: PNI and GNRI indexes did not show a significant association with both PFS and OS, while CONUT index displayed a significant difference in PFS between the two groups, in favor of the control group (Z = 4.04; p < 0.01) also without any publication bias (β= -1.27; 95% CI = [-2.13; -0.42]; p = 0.10]). The same trend was recorded in OS, too (Z = 4.24; p < 0.01). However, publication bias was present (β = 1.89; 95% CI = [1.26; 2.54]; p = 0.028]) and the numerosity of the studies did not reveal the sufficient statistical power to obtain reliable results.

CONCLUSION: Malnutrition could negatively impact cancer patients, especially in advanced phases. Our findings could be associated with the reduction of physical ability and daily activity performance, lower compliance with treatment protocols, and shorter survival outcomes.

PMID:40134096 | PMC:PMC12013447 | DOI:10.1080/1750743X.2025.2483656

Results of malnutrition risk self-screening in Hungarian oncology patients

Thu, 20 Mar 2025 20:00:00 -0400

Magy Onkol. 2025 Mar 21;69(1):77-79. Epub 2024 Dec 3.

ABSTRACT

AIM: Our aim was to introduce self-screening for the risk of malnutrition in cancer patients using the PG-SGA questionnaire, and to compare the results of the new method with the abnormal values of the previously used BMI and MUST method.

METHODS: We performed self-screening using the PGSGA questionnaire, MUST risk screening, and nutritional status classification based on BMI in parallel with 101 oncology patients.

RESULTS: A high risk of malnutrition was diagnosed in 73 subjects (72%) using the PG-SGA method, 58 subjects (57%) using the MUST method, and 8 subjects (8%) using the BMI method.

CONCLUSIONS: The PG-SGA method can be easily implemented in the Hungarian practice, which effectively screens the risk of malnutrition in cancer patients. The sensitivity of the questionnaire is increased by the disease-specific questions, which ask about symptoms affecting nutrition and stress factors that determine metabolic demand. Early detection of malnutrition and the initiation of nutritional therapy in cancer are key factors in terms of improving quality of life and increasing survival.

PMID:40117488

Using a nomogram based on the controlling nutritional status score to predict prognosis after surgery in patients with resectable gastric cancer

Mon, 17 Mar 2025 20:00:00 -0400

BMC Gastroenterol. 2025 Mar 17;25(1):180. doi: 10.1186/s12876-025-03766-6.

ABSTRACT

BACKGROUND: Various studies have shown that the controlling nutritional status (CONUT) score contributes to assessing the prognosis of cancer patients. This study aimed to establish a nomogram based on the CONUT score and several other important parameters based on patient age and tumor characteristics to accurately forecast the overall survival (OS) of patients with resectable gastric cancer (GC).

METHODS: This study retrospectively recruited 404 individuals who received a potentially curative radical gastrectomy performed by the same group of surgeons at our medical center from January 2019 to December 2021. We used Cox regression analysis to identify independent prognostic factors influencing patients' OS. We establish a nomogram based on the outcomes of the multivariate analysis to forecast the 1, 2, and 3-year OS of GC patients.

RESULTS: Univariate Cox regression analysis revealed that the age, body mass index (BMI), hemoglobin (HGB), serum albumin (ALB), Serum carcinoembryonic antigen (CEA), CONUT score, tumor size, pT stage, pN stage, nerve invasion, vascular invasion, tumor differentiation, and postoperative chemotherapy were prognostic indicators of postoperative OS in GC patients (all P < 0.05). Multivariate Cox regression analysis indicated that the age (P = 0.015), CONUT score (P = 0.002), pT stage (T3 vs T1: P = 0.011, T4 vs T1: P = 0.026), pN stage (N2 vs N0: P = 0.002, N3 vs N0: P < 0.001), nerve invasion (P = 0.021) were the independent risk factors. The nomogram based on the CONUT score, with a C-index of 0.792, enhanced the predictive ability of the TNM staging system alone, which had a C-index of 0.718 for OS.

CONCLUSION: The CONUT score can independently predict the OS for individuals with GC following surgery. The nomogram based on the CONUT score is a reliable tool for forecasting the postoperative survival of individuals with GC and may identify those patients wholesale benefit from a more aggressive treatment protocol.

PMID:40097940 | PMC:PMC11916987 | DOI:10.1186/s12876-025-03766-6

Nutritional Status and Its Impact on Treatment Tolerance in Non-Small-Cell Lung Cancer Patients Receiving Osimertinib

Wed, 12 Mar 2025 20:00:00 -0400

Nutrients. 2025 Mar 6;17(5):927. doi: 10.3390/nu17050927.

ABSTRACT

Background/Objectives: Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases and is a leading cause of morbidity and mortality worldwide. Between 35% and 65% of NSCLC patients experience nutritional problems or malnutrition, which significantly affects their prognosis and quality of life. This study aims to describe the nutritional status and body composition of NSCLC patients treated with osimertinib, an oral tyrosine kinase inhibitor, while also assessing the prevalence of sarcopenia, presarcopenia, and dynapenia. Additionally, we explore the relationship between dose-limiting toxicities (DLTs) and nutritional status, as well as the impact of nutritional status on quality of life using the EQ-5D scale. Methods: A cross-sectional, observational study was conducted in 25 adult patients diagnosed with NSCLC treated with osimertinib under pharmacotherapeutic follow-up in the Pharmacy Consultations of a tertiary-level hospital. Anthropometric parameters, body composition (via bioimpedance analysis), and muscle functionality (via dynamometry) were assessed. Quality of life was evaluated using the EQ-5D scale. Results: The results showed that 36% of patients were malnourished, 4% had sarcopenia, 8% were presarcopenic, and 20% had dynapenia. Patients with DLTs exhibited significantly lower values of fat-free mass and the fat-free mass index, suggesting a relationship between low muscle mass and increased toxicities. Conclusions: These findings underscore the importance of early, individualized nutritional interventions in NSCLC patients treated with osimertinib to improve nutritional status and optimize oncological outcomes. Further research with larger cohorts and longitudinal designs is necessary to confirm these findings.

PMID:40077797 | PMC:PMC11901973 | DOI:10.3390/nu17050927

Association between prognostic immune nutritional index and disease-free survival in adults with esophageal cancer following surgery: A retrospective cohort study

Thu, 06 Mar 2025 19:00:00 -0500

JPEN J Parenter Enteral Nutr. 2025 May;49(4):497-506. doi: 10.1002/jpen.2740. Epub 2025 Mar 6.

ABSTRACT

INTRODUCTION: The clinical significance of the prognostic immune nutritional index in esophageal cancer has not been elucidated. The aim of this study was to evaluate the utility of the preoperative prognostic immune nutritional index in predicting oncological outcomes and the incidence of surgical site infection in patients with esophageal cancer.

METHODS: We analyzed preoperative prognostic immune nutritional index from 150 esophageal cancer patients who underwent surgical treatment between 2008 and 2018 to clarify its clinical relevance.

RESULTS: Patients with low preoperative prognostic immune nutritional index exhibited poor disease-free survival and overall survival (P = 0.030 and P < 0.001, respectively). Although statistical significance was not observed in the multivariate analysis, low prognostic immune nutritional index showed a tendency toward poorer disease-free survival (hazard ratio [HR]: 2.02; 95% confidence interval [CI]: 0.88-4.61; P = 0.096). Regarding overall survival, multivariate analysis revealed that low preoperative prognostic immune nutritional index was an independent prognostic factor for overall survival (HR: 2.67; 95% CI: 1.39-5.16; P = 0.003). Moreover, the low preoperative prognostic immune nutritional index was associated with a tendency toward an increased risk of surgical site infection (odds ratio: 2.38; 95% CI: 0.96-5.91; P = 0.062). In the subgroup analysis of patients who did not receive neoadjuvant therapy, low preoperative prognostic immune nutritional index was identified as an independent prognostic factor for disease-free survival (HR: 3.11; 95% CI: 1.00-9.71; P = 0.050) and overall survival (HR: 5.04; 95% CI: 1.80-14.13; P = 0.002).

CONCLUSION: The preoperative prognostic immune nutritional index is a useful marker for perioperative and oncological management of esophageal cancer patients.

PMID:40051181 | PMC:PMC12053140 | DOI:10.1002/jpen.2740

The CONUT Score Can Predict the Prognosis of Gastric Cancer Patients After Curative Treatment

Mon, 03 Mar 2025 19:00:00 -0500

Anticancer Res. 2025 Mar;45(3):1251-1260. doi: 10.21873/anticanres.17512.

ABSTRACT

BACKGROUND/AIM: Malnutrition is a reported prognostic factor in patients with cancer. The controlling nutritional status (CONUT) score, an index calculated from routine laboratory tests, is correlated with the prognosis of various cancers. This study examined the relationship between the CONUT score and prognosis of patients with gastric cancer (GC) after radical gastrectomy.

PATIENTS AND METHODS: Patients with GC who underwent curative gastrectomy were retrospectively reviewed. Patient characteristics, laboratory data, pathological findings, perioperative clinical course, and survival outcomes were recorded. The CONUT score was calculated using serum albumin (mg/dl), total cholesterol (mg/dl), and lymphocyte count (cells/mm³). Based on previous studies, patients were categorized into normal (CONUT score <2) and malnutrition (CONUT score ≥2) groups. Prognostic factors were compared between the groups.

RESULTS: In total, 155 patients were included (median age, 69 years; male, n=110; female, n=45). Five-year overall survival (OS) was significantly lower in the malnutrition group (malnutrition group, 42.2%; normal group, 82.7% p<0.001). A multivariate analysis identified the CONUT score as an independent prognostic factor for OS [HR=2.506; 95% confidence interval (CI)=1.288-4.873, p=0.007]. Similar results were obtained for recurrence-free survival (RFS). Additionally, postoperative complications were more frequent (malnutrition group, 44.2%; normal group, 25.9%; p=0.027) and the chemotherapy introduction rate for pStage III or III was lower (malnutrition group, 55.6%; normal group, 78.8%, p=0.054) in the malnutrition group.

CONCLUSION: The CONUT score may be an independent prognostic factor for OS and RFS in patients with GC after curative gastrectomy. CONUT scores of ≥2 were associated with higher postoperative complications and lower chemotherapy rates, which may contribute to a poor prognosis.

PMID:40037866 | DOI:10.21873/anticanres.17512

Nutritional Assessment and Management of Patients with Brain Neoplasms Undergoing Neurosurgery: A Systematic Review.

Sat, 01 Mar 2025 00:00:00 -0500

Cancers; 03/01/2025
(AN 183650599); ISSN: 20726694
CINAHL Complete

Impact of Nutritional Changes on the Prognosis in Pancreatic Cancer Patients Underwent Curative Surgery After Neoadjuvant Chemotherapy

Tue, 25 Feb 2025 19:00:00 -0500

Nutrients. 2025 Feb 11;17(4):647. doi: 10.3390/nu17040647.

ABSTRACT

BACKGROUND: Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. Neoadjuvant chemotherapy (NAC) is increasingly used to improve survival in patients with pancreatic cancer; however, it often results in nutritional deterioration, which may negatively impact patient outcomes. Therefore, this study aimed to assess the effect of changes in nutritional status on the long-term outcomes of patients with pancreatic cancer who underwent curative surgery after NAC.

METHODS: This retrospective single-center study included 148 patients with pancreatic cancer who underwent curative surgery after NAC between 2010 and 2020. The Controlled Nutritional Status (CONUT) score was used to determine the nutritional status of the patients. Patients were categorized into worsened, maintained, and improved groups based on the changes in their CONUT scores before and after NAC. We compared differences in overall survival (OS) and disease-free survival (DFS) between the groups.

RESULTS: The worsened nutritional status group exhibited the shortest median OS (28 months) compared to the maintained and improved groups (39 and 66 months, respectively; p = 0.01). Additionally, the worsened group demonstrated the shortest DFS compared to the other two groups (13, 22, and 39 months, respectively; p = 0.02). Multivariate analysis identified nutritional deterioration as an independent prognostic factor for OS (hazard ratios (HR), 2.11; 95% confidence intervals (CI), 1.31-3.40; p < 0.01).

CONCLUSIONS: Nutritional deterioration after NAC is a significant prognostic factor of poor survival outcomes in patients with pancreatic cancer. These findings indicate that serial nutritional assessments and treatment during NAC are crucial for improving patient outcomes.

PMID:40004975 | PMC:PMC11858578 | DOI:10.3390/nu17040647

Association of prognostic nutritional index with long-term survival in lung cancer receiving immune checkpoint inhibitors: A meta-analysis

Tue, 18 Feb 2025 19:00:00 -0500

Medicine (Baltimore). 2024 Dec 27;103(52):e41087. doi: 10.1097/MD.0000000000041087.

ABSTRACT

BACKGROUND: This meta-analysis aimed to identify the association of prognostic nutritional index (PNI) with long-term survival in lung cancer patients who received the immune checkpoint inhibitors.

METHODS: The Medline, CNKI, EMBASE, and Web of Science databases were searched up to August 20, 2023. Progression-free survival (PFS) and overall survival (OS) were main outcomes and hazard ratios (HRs) and 95% confidence intervals were combined. Subgroup analysis stratified by the pathological type [non-small cell lung cancer (NSCLC) vs small cell lung cancer (SCLC)], previous treatment history and combination of other treatment was performed.

RESULTS: Twenty-two available studies with 2550 patients were included. Pooled results demonstrated that lower PNI was related to worse PFS (HR = 0.51, P<.001) and OS (HR = 0.43, P<.001). Furthermore, subgroup analysis based on the pathological type (non-small cell lung cancer: HR = 0.52, P<.001 for PFS, HR = 0.41, P<.001 for OS; small cell lung cancer: HR = 0.41, P = .007 for PFS, HR = 0.44, P = .007 for OS), previous treatment history (first-line treatment: HR = 0.67, P<.001 for PFS, HR = 0.52, P<.001 for OS) and combination of other treatment (No: HR = 0.54, P<.001 for PFS, HR = 0.43, P<.001 for OS; Yes: HR = 0.63, P<.001 for PFS, HR = 0.51, P<.001) showed similar findings.

CONCLUSION: PNI is significantly associated with long-term survival in immune checkpoint inhibitors treated lung cancer and patients with lower PNI are more likely to experience poorer prognosis.

PMID:39969311 | PMC:PMC11688013 | DOI:10.1097/MD.0000000000041087

The impact of preoperative immunonutritional status on prognosis in ovarian cancer: a multicenter real-world study

Mon, 17 Feb 2025 19:00:00 -0500

J Ovarian Res. 2025 Feb 17;18(1):30. doi: 10.1186/s13048-025-01607-4.

ABSTRACT

BACKGROUND: To investigate the effect of preoperative immunonutritional status on prognosis in epithelial ovarian cancer patients.

METHODS: A multicenter real-world study included 922 patients with histologically confirmed epithelial ovarian cancer who received comprehensive staged surgery or debulking surgery at seven tertiary hospitals in China between 2012 and 2023. Prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) were used to assess the immunonutritional status for their superior predictive power to indicate the nutritional status and the inflammatory immunity. Cox regression analyses were employed to identify variables associated with progression-free survival (PFS) and overall survival (OS).

RESULTS: In the early-stage cohort of 224 epithelial ovarian cancer patients, the optimal cut-off value for PNI was 47.47 for both PFS and OS, while the optimal cut-off value for SII values were 551.37 for PFS and 771.78 for OS. In the late-stage group of 698 patients, the optimal PNI thresholds were 47.76 for PFS and 46.00 for OS, with SII values of 720.96 for PFS and 1686.11 for OS. In multivariate analysis of early-stage patients, high PNI was an independent protective factor for PFS (hazard ratio (HR), 0.39 (95% confidence interval (CI) 0.20-0.76), P = 0.006) and OS (HR, 0.44 (95% CI 0.20-0.97), P = 0.042), respectively. High SII was significantly associated with PFS (HR, 2.43 (95% CI 1.23-4.81), P = 0.011) and marginally unfavorable for OS (HR, 2.05 (95% CI 0.96-4.39), P = 0.064). In advanced population, PNI (HR, 0.77 (95% CI 0.60-0.99), P = 0.043) and SII (HR, 1.34 (95% CI 1.01-1.78), P = 0.041) were independent prognostic factors for OS but had no impact on PFS (P = 0.185, P = 0.188, respectively).

CONCLUSION: Poor preoperative immunonutritional status has a deleterious effect on the prognosis of patients with ovarian cancer. Intervention in patients suffering from suboptimal preoperative immunonutritional status may facilitate improved survival outcomes.

PMID:39962572 | PMC:PMC11831797 | DOI:10.1186/s13048-025-01607-4

Impact of Nutritional Changes on the Prognosis in Pancreatic Cancer Patients Underwent Curative Surgery After Neoadjuvant Chemotherapy.

Sat, 15 Feb 2025 00:00:00 -0500

Nutrients; 02/15/2025
(AN 183286898); ISSN: 20726643
CINAHL Complete

Geriatric Nutritional Risk Index (GNRI) and Survival in Pancreatic Cancer: A Retrospective Study

Wed, 12 Feb 2025 19:00:00 -0500

Nutrients. 2025 Jan 30;17(3):509. doi: 10.3390/nu17030509.

ABSTRACT

INTRODUCTION: Malnutrition is a major contributor to poor treatment and survival outcomes in pancreatic cancer, yet nutritional assessment is not standardized or consistently implemented in the care of oncology patients. The Geriatric Nutritional Risk Index (GNRI), calculated from serum albumin and body weight, may be useful as a practical tool for identifying patients at risk of poor nutritional status. Purpose: To provide a preliminary analysis using a limited selection of variables to examine the association of the GNRI at diagnosis and the GNRI change over time with overall survival in patients with pancreatic cancer.

METHODS: This retrospective study included 314 patients aged ≥18 years with pancreatic cancer. The GNRI was calculated at diagnosis and ≥30 days later. Patients were categorized by the GNRI at diagnosis (no risk >98, any risk ≤98) and change in the GNRI over time (no change/increase, mild decrease, and severe decrease). Additional variables included were demographics and stage. Comparative analysis included t-tests, chi-square tests, and ANOVA. Survival was analyzed using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards modeling.

RESULTS: Median survival was significantly decreased in patients in the any-nutritional-risk group compared to the no-nutritional-risk group at diagnosis (442 vs. 1105 days), and those experiencing severe decreases in the GNRI scores compared to mild decreases and no change or increases (372.5 vs. 712 vs. 1791 days), respectively. Survival analysis stratified by the GNRI at diagnosis shows that both mild (HR 2.19, 95%, and CI 1.46-3.30) and severe decreases (HR 4.04, 95%, and CI 2.64-6.18) in the GNRI scores were independently associated with decreased survival versus no change or increase in the GNRI group after controlling for stage. Log-rank tests also show patients with any nutritional risk at diagnosis had significantly lower survival than those with no nutritional risk (p = 0.00052).

CONCLUSIONS: Lower GNRI scores showing greater nutritional risk at diagnosis and decreasing GNRI scores over time were predictors of decreased survival in pancreatic cancer. Our findings indicate that the GNRI may be valid and effective for the early identification of patients with a high nutritional risk who require nutritional interventions to improve outcomes in pancreatic cancer. However, more research is needed using larger samples and a greater variety of variables to confirm the presence and strength of this relationship, examine the effect of patient factors known to be associated with survival and nutrition, and explore potential influential confounders.

PMID:39940367 | PMC:PMC11819935 | DOI:10.3390/nu17030509

Association of nutritional and inflammatory status with patient self-reported symptoms in oesophageal cancer patients: A multicentre cross-sectional study

Tue, 11 Feb 2025 19:00:00 -0500

Eur J Oncol Nurs. 2025 Apr;75:102816. doi: 10.1016/j.ejon.2025.102816. Epub 2025 Feb 4.

ABSTRACT

PURPOSE: Nutritional and inflammatory status is heterogeneous among oesophageal cancer patients and affects the recovery of patients' postoperative symptoms. We conducted this study to identify classes of nutritional and inflammatory status in oesophageal cancer patients, providing a basis for precise interventions to improve long-term prognosis and survival.

METHODS: Patients' preoperative nutritional and inflammatory status was obtained based on haematological tests. Self-reported symptoms were measured using the Recovery Symptom Assessment Scale for Patients Undergoing Oesophageal Cancer Resection. Latent class analysis analyses were used to identify heterogeneity in inflammation and nutrition in oesophageal cancer patients. Analysis of variance was used to test for differences in symptoms among patients with different inflammatory and nutritional status.

RESULTS: The Latent class analysis identifies three classes of body composition: "Low Inflammation-Good nutrition Group", "High Inflammation-Good nutrition Group " and "High Inflammation-Poor nutrition Group". Analysis of variance showed that the recovery of early postoperative symptoms and early recovery symptoms differed between the classes of oesophageal cancer patients.

CONCLUSIONS: Different classes of preoperative nutritional and inflammatory status exist in oesophageal cancer patients, and there are differences between early recovery symptoms and psychosocial symptoms between these classes. Therefore, early assessment of the class of body composition in patients with oesophageal cancer is essential to improve their symptoms. Scientific and effective symptomatic interventions should be further explored in the future to improve the long-term prognosis of oesophageal cancer patients.

PMID:39938237 | DOI:10.1016/j.ejon.2025.102816

Sensorineural hearing loss after concurrent chemoradiotherapy with high-dose cisplatin in head and neck cancer patients: Roles of nutrition and trace elements

Wed, 05 Feb 2025 19:00:00 -0500

Auris Nasus Larynx. 2025 Apr;52(2):141-145. doi: 10.1016/j.anl.2025.01.013. Epub 2025 Feb 5.

ABSTRACT

OBJECTIVE: Sensorineural hearing loss (SNHL) is one of the most important adverse events of concurrent chemoradiotherapy (CCRT) with high-dose cisplatin for locally advanced head and neck squamous cell carcinoma (HNSCC). This retrospective study aimed to elucidate the effects of nutritional status and trace elements on the development of SNHL.

METHODS: A retrospective review of 211 ears from 109 patients with HNSCC who underwent CCRT with high-dose cisplatin was performed. SNHL of each ear was classified according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, and possible contributing factors were evaluated by univariate and multivariate analyses. Age, sex, primary site, clinical stage, treatment intent, smoking and drinking habits, history of hypertension, diabetes mellitus, body mass index, serum albumin, trace elements (Fe, Zn, Cu, Se), pretreatment average hearing level at 2-8 kHz, weight loss rate, cumulative cisplatin dose, and inner ear radiation dose were the variables evaluated.

RESULTS: Ordinal logistic regression analysis showed that increased age, better pretreatment average hearing level at 2-8 kHz, and cumulative cisplatin dose were independent factors associated with the development of SNHL.

CONCLUSION: Nutritional status and trace elements were not associated with the development of SNHL caused by CCRT with high-dose cisplatin.

PMID:39914173 | DOI:10.1016/j.anl.2025.01.013

Clinical and Nutritional Aspects and Outcomes of Covid-19 in Cancer and Non-Cancer Pediatric Patients.