IMMEDIATE PREOPERATIVE NUTRITIONAL STATUS OF PATIENTS WITH COLORECTAL CANCER: a warning

Abstract

-Context -Weight loss and malnutrition are disorders observed in colorectal cancer patients. Objetives -We sought to evaluate the immediate preoperative nutritional status of patients with colorectal cancer. Methods -This is a cross-sectional clinical study conducted at a single center. Sixty-six consecutive patients in preoperative for elective surgical treatment were studied. The clinical history, socio-demographic data and nutritional status of the patients were evaluated using Subjective Global Assessment and objective (anthropometry) methods. The primary outcome measures were nutritional status classification as nourished or malnourished and the relationship between nutritional status and socio-demographic and clinical features. Results -Most of patients exhibited left colon tumors and disease stage II. According to the Subjective Global Assessment, 36.4% of patients were malnourished. Malnutrition ranged from 7.6% to 53% depending on the evaluation method used, with poor correlation to Subjective Global Assessment. The prevalence of malnutrition was significantly greater in females and non-married patients and in those with two or more symptoms of colorectal cancer. Conclusion -More than a third of patients in the immediate preoperative period for colorectal cancer exhibited malnutrition. Therefore, routine nutritional assessment is highly advisable so that appropriate measures may be taken to minimize the potential postoperative complications. HEADINGS -Colorectal neoplasms. Preoperative period. Malnutrition. Nutrition assessment.

Pre‐operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight‐losing patients with colorectal cancer: single‐blind randomized controlled trial

“…Percentage weight loss is included as it is part of the criteria that is used to define malnutrition 22 and has universally been used as a prognostic variable for predicting post-operative outcome. 6 Handgrip strength was measured by using the non-dominant hand (Takei 5001 Grip Dynamometer Analogue). Three measurements were taken and the mean recorded.…”

“…To calculate percentage weight loss, the participants were asked to recall their previous weight (3–6 months ago); this was used with actual weight recorded at all time points to determine percentage weight loss. Percentage weight loss is included as it is part of the criteria that is used to define malnutrition and has universally been used as a prognostic variable for predicting post‐operative outcome . Handgrip strength was measured by using the non‐dominant hand (Takei 5001 Grip Dynamometer Analogue).…”

“…[3][4][5] However, despite this, neither pre-operative nutritional assessment nor nutritional screening is commonly practiced or integrated into the care pathways for patients with colorectal cancer. 2 In pre-operative patients with colorectal cancer, the prevalence of malnutrition has been reported as 36.4% by using subjective global assessment, whilst clinically significant or severe weight loss has been reported in 39% 6 and any weight loss in 47% of people with colorectal cancer. 7 The combination of a low muscle mass and impaired physical function referred to as sarcopenia 8 has been identified in 12% of people with pre-operative colorectal cancer by using computed tomography to measure muscle mass and is associated with older age, lower body mass index, and increased rate of post-operative complications.…”

Attitudes of Surgeons toward Elderly Cancer Patients: A Survey from the SIOG Surgical Task Force

“…Barbosa et al [14] showed that 36.4% of patients with colorectal cancer (CRC) were malnourished preoperatively. van Stijn et al [15] performed a systematic review over 10 years to assess the role of evaluation of preoperative nutrition parameters in predicting postoperative outcomes in elderly patients.…”

Perioperative nutrition management as an important component of surgical capacity in low‐ and middle‐income countries

“…Reports have indicated that the prevalence of hospital malnutrition is as high as 50% in HICs and approximately 70% in LMICs . Studies in LMICs show that the prevalence of pre‐operative malnutrition among surgical patients is also high (Table ) . Of these studies, 16 were from Latin American countries, 7 from China, 3 from Vietnam, 3 from Turkey, 2 from India and 1 from Thailand.…”