Impact of malnutrition as defined by the GLIM criteria on treatment outcomes in patients with cancer: A systematic review and meta-analysis

Matsui, Ryota; Rifu, Kazuma; Watanabe, Jun; Inaki, Noriyuki; Fukunaga, Tetsu

doi:10.1016/j.clnu.2023.02.019

Cited by 22 publications

(16 citation statements)

References 97 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This difference may be attributed to their inclusion of patients who underwent radical gastrectomy while excluding those with stage IV cancer. As the global consensus on diagnostic criteria for malnutrition, GLIM-de ned malnutrition has been demonstrated to be signi cantly associated with an increased risk of postoperative complications and poor survival in various cancer [16][17][18] , including gastrointestinal cancer 19 . The application of GLIM criteria for assessing malnutrition in cancer patients can provide valuable insights for guiding nutrition management and intervention strategies.…”

Section: Discussionmentioning

confidence: 99%

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer

Junbo,

Yan

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective This study aimed to compare three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer (GC). Method Objective nutritional screening tools including geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were evaluated in patients with GC at our institution. Malnutrition was diagnosed according to the GLIM criteria. The diagnostic value of GNRI, PNI, and COUNT scores in identifying GLIM-defined malnutrition was assessed by conducting Receiver Operating Characteristic (ROC) curves and calculating the area under the curve (AUC). Additionally, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined. The Kappa coefficient (k) was used to assess agreement between three objective nutritional screening tools and GLIM criteria. Results A total of 316 patients were enrolled in this study, and malnutrition was diagnosed in 151 patients (47.8%) based on the GLIM criteria. The GNRI demonstrated good diagnostic accuracy (AUC = 0.805, 95% CI: 0.758–0.852) for detecting GLIM-defined malnutrition, while the PNI and COUNT score showed poor diagnostic accuracy with AUCs of 0.699 (95% CI: 0.641–0.757) and 0.665 (95% CI: 0.605–0.725) respectively. Among these objective nutritional screening tools, the GNRI-based malnutrition risk assessment demonstrated the highest specificity (80.0%), accuracy (72.8%), PPV (74.8%), NPV (71.4%), and consistency (k = 0.452) with GLIM-defined malnutrition. Conclusions Compared to PNI and COUNT scores, GNRI demonstrated superior performance as an objective nutritional screening tool for identifying GLIM-defined malnutrition in GC patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer

Junbo,

Yan

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In a recent systematic review including 11,700 cancer patients, the prognostic impact of malnutrition on outcomes was analyzed with a meta-analytic approach. 33 Eight out of ten studies evaluated surgical patients, and in most studies the assessment of fat-free mass was done by measuring calf/arm circumference, or on CT scan. Only one study on esophageal cancer assessed lean mass using bioimpedance.…”

Section: Discussionmentioning

confidence: 99%

Predicting the Risk of Morbidity by GLIM-Based Nutritional Assessment and Body Composition Analysis in Oncologic Abdominal Surgery in the Context of Enhanced Recovery Programs

Sandini,

Gianotti,

Paiella

et al. 2024

Ann Surg Oncol

View full text Add to dashboard Cite

Background Preoperative nutritional status and body structure affect short-term prognosis in patients undergoing major oncologic surgery. Bioimpedance vectorial analysis (BIVA) is a reliable tool to assess body composition. Low BIVA-derived phase angle (PA) indicates a decline of cell membrane integrity and function. The aim was to study the association between perioperative PA variations and postoperative morbidity following major oncologic upper-GI surgery. Patients and Methods Between 2019 and 2022 we prospectively performed BIVA in patients undergoing surgical resection for pancreatic, hepatic, and gastric malignancies on the day before surgery and on postoperative day (POD) 1. Malnutrition was defined as per the Global Leadership Initiative on Malnutrition criteria. The PA variation (ΔPA) between POD1 and preoperatively was considered as a marker for morbidity. Uni and multivariable logistic regression models were applied. Results Overall, 542 patients with a mean age of 64.6 years were analyzed, 279 (51.5%) underwent pancreatic, 201 (37.1%) underwent hepatobiliary, and 62 (11.4%) underwent gastric resections. The prevalence of preoperative malnutrition was 16.6%. The overall morbidity rate was 53.3%, 59% in those with ΔPA < −0.5 versus 46% when ΔPA ≥ −0.5. Age [odds ratio (OR) 1.11; 95% confidence interval (CI) (1.00; 1.22)], pancreatic resections [OR 2.27; 95% CI (1.24; 4.18)], estimated blood loss (OR 1.20; 95% CI (1.03; 1.39)], malnutrition [OR 1.77; 95% CI (1.27; 2.45)], and ΔPA [OR 1.59; 95% CI (1.54; 1.65)] were independently associated with postoperative complications in the multivariate analysis. Conclusions Patients with preoperative malnutrition were significantly more likely to develop postoperative morbidity. Moreover, a decrease in PA on POD1 was independently associated with a 13% increase in the absolute risk of complications. Whether proactive interventions may reduce the downward shift of PA and the complication rate need further investigation.

show abstract

“…Since its publication in 2019, the GLIM criteria have been adopted in a wealth of studies, giving rise to a good basis for comparison of our own findings. [25][26][27][28] In hepatology, previous reports are heterogeneous of the target population (outpatient vs. inpatient), disease severity (decompensation vs. compensation), practical procedure (with vs. without screening step), and criteria combination, giving rise to a wide variation in the prevalence from 0.7% to 57.3%. [29][30][31][32][33] Casas Deza et al 30 reported malnutrition in 38.1% and Zhang et al 33 in 42.3% of patients with cirrhosis, although the GLIM was selected as "gold standard" for the diagnosis of malnutrition, which is similar to our results.…”

Section: Discussionmentioning

confidence: 99%

“…Malnutrition was assessed according to the GLIM criteria, a consensus definition aiming to harmonize malnutrition diagnosis. Since its publication in 2019, the GLIM criteria have been adopted in a wealth of studies, giving rise to a good basis for comparison of our own findings 25–28 . In hepatology, previous reports are heterogeneous of the target population (outpatient vs. inpatient), disease severity (decompensation vs. compensation), practical procedure (with vs. without screening step), and criteria combination, giving rise to a wide variation in the prevalence from 0.7% to 57.3% 29–33 .…”

Section: Discussionmentioning

confidence: 99%

The relationship between sarcopenia, multidimensional frailty, and malnutrition cluster and long‐term mortality in hospitalized patients with cirrhosis

Guo,

Wang,

Yang

et al. 2023

Portal Hypertension & Cirrhosis

View full text Add to dashboard Cite

Aim Sarcopenia, multidimensional frailty, and malnutrition represent common debilitating conditions in the context of cirrhosis, linked to a variety of dismal outcomes. We aimed to clarify their overlap and cumulative impact on long‐term mortality in hospitalized patients with cirrhosis. Methods Consecutive patients with cirrhosis were prospectively recruited from January 2018 to December 2020. The diagnosis of sarcopenia, multidimensional frailty, and malnutrition was standardized according to the consensus definition and our well‐documented criteria. The prevalence of the respective debilitating condition and the concurrence of this comorbidity were calculated. Results In total, 253 patients with cirrhosis aged 64 years with a female predominance (52.4%) were recruited. Sarcopenia was present in 20.9% (53/253), multidimensional frailty in 12.6% (32/253), and malnutrition in 44.7% (113/253) of the entire cohort. Approximately half of the patients had at least one debilitating condition (127/253). Sarcopenia and malnutrition co‐existed in 33 nonfrail patients (13.0%) and multidimensional frailty and malnutrition in eight nonsarcopenic patients (3.2%). Fifteen (5.9%) subjects had all three debilitating conditions, namely malnutrition, sarcopenia, and frailty (MSF) group. The proportions of males, infections, and ascites were significantly higher in the MSF group. Patients in the MSF group had the highest levels of neutrophil‐to‐lymphocyte ratio and creatinine. The 2‐year mortality rates in patients with three debilitating conditions, two conditions, one condition, and no conditions were 60.0%, 23.8%, 21.4%, and 13.5%, respectively. Multivariate Cox regression indicated the long‐term mortality risk was approximately four‐fold higher among patients in the MSF group compared to those with no conditions. Conclusions A fraction of patients with cirrhosis exhibited comorbidities of sarcopenia, multidimensional frailty, and malnutrition, linked to a higher risk of long‐term mortality.

show abstract

Impact of malnutrition as defined by the GLIM criteria on treatment outcomes in patients with cancer: A systematic review and meta-analysis

Cited by 22 publications

References 97 publications

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer

Predicting the Risk of Morbidity by GLIM-Based Nutritional Assessment and Body Composition Analysis in Oncologic Abdominal Surgery in the Context of Enhanced Recovery Programs

The relationship between sarcopenia, multidimensional frailty, and malnutrition cluster and long‐term mortality in hospitalized patients with cirrhosis

Contact Info

Product

Resources

About