Clinical Value of Nutritional Status in Cancer: What is its Impact and how it Affects Disease Progression and Prognosis?

Abstract

Malnutrition is a common finding in cancer patients, which can affect disease progression and survival. This review aims to critically summarize the prognostic role of nutritional status, from Body Mass Index (BMI) and weight loss to nutrition screening tools and biochemical indices, in cancer patients. According to the currently available data, Prognostic Nutritional Index (PNI) was a significant prognostic factor of patients' survival, both in univariate and multivariate analyses. Pre-operative albumin was also correlated with worse outcomes, being an independent prognostic factor of survival in several studies. BMI was also well-studied, with contradictory results. Although, lower BMI was found to be an independent prognostic factor of shorter survival in some studies, in others it did not have an impact on survival. In this aspect, this review highlights the significant prognostic role of nutritional status in the disease progression and survival of cancer patients. Further, good-quality prospective studies are needed in order to draw precise conclusions on the prognostic role of specific nutritional assessment tools, and biochemical indices associated with the nutritional status in more cancer types, such as liver, breast and prostate cancer, and hematological malignancies.

Validation of the preoperative controlling nutritional status score as an independent predictor in a large Chinese cohort of patients with upper tract urothelial carcinoma

“…Malnutrition is a common phenomenon which can be found in cancer patients and previous evidence support that malnutrition was associated with worse outcomes . In the study conducted by Naito et al they defined CONUT score 5‐12 as malnutrition status.…”

Influence of peritoneal carcinomatosis on perioperative outcome in palliative gastric bypass for malignant gastric outlet obstruction - a retrospective cohort study

“…In addition to malnutrition, tumor cachexia, a complex multifactorial condition that arises from a combination of metabolic alterations, systemic inflammation, and decreased appetite, is also a major concern in patients with increased tumor burden [22]. Tumor cachexia is directly associated with malnutrition and associated with impaired wound healing, increased risk for surgical complications, and impaired overall outcome [23,24].…”

Predictive value of CONUT score combined with serum CA199 levels in postoperative survival of patients with pancreatic ductal adenocarcinoma: a retrospective study

“…Relevant reports have shown that the prognosis of tumor is closely related to the inflammatory status, immune function and nutritional status of patients (Mantzorou et al, 2017;Ni et al, 2019;Van Dijk & Pot, 2016;Xiao et al, 2019). Numerous studies have found that malnutrition significantly increases postoperative complications and has a negative impact on the quality of life, hospital stay, anti-cancer treatment effect and overall survival in cancer patients (Borre et al, 2018;Fujiya et al, 2018;Lin et al, 2019).…”