Nutritional Status of Pediatric Cancer Patients at Diagnosis and Correlations with Treatment, Clinical Outcome and the Long-Term Growth and Health of Survivors

Abstract

Malnutrition is caused either by cancer itself or by its treatment, and affects the clinical outcome, the quality of life (QOL), and the overall survival (OS) of the patient. However, malnutrition in children with cancer should not be accepted or tolerated as an inevitable procedure at any stage of the disease. A review of the international literature from 2014 to 2019 was performed. Despite the difficulty of accurately assessing the prevalence of malnutrition, poor nutritional status has adverse effects from diagnosis to subsequent survival. Nutritional status (NS) at diagnosis relates to undernutrition, while correlations with clinical outcome are still unclear. Malnutrition adversely affects health-related quality of life (HRQOL) in children with cancer and collective evidence constantly shows poor nutritional quality in childhood cancer survivors (CCSs). Nutritional assessment and early intervention in pediatric cancer patients could minimize the side effects of treatment, improve their survival, and reduce the risk of nutritional morbidity with a positive impact on QOL, in view of the potentially manageable nature of this risk factor.

Nutritional Status in Childhood Cancer Survivors with Solid Tumors: A Longitudinal Study

“…Children with solid tumors are more likely to be undernourished at diagnosis and early in treatment compared to patients with hematological malignancy or brain tumors, 3,11,12 yet it can be difficult evaluating NS in the solid tumor population as weight may be affected by large tumor burdens (i.e. neuroblastoma, hepatoblastoma), changes in fluid status and body composition.…”

“…3 Undernutrition was reported in children with cancer as early as the 1970's, 9 and continues at diagnosis and during treatment. 3,[10][11][12][13][14][15] The incidence of undernutrition and overnutrition at diagnosis in children with cancer ranges from 0-65% and 8-30%, respectively, depending on cancer type and methods used to classify nutritional status (NS). 3,12,[15][16][17][18] Children with solid tumors have the highest rates of undernutrition initially in treatment, compared to those with brain tumors and hematological malignancies.…”

“…3,[10][11][12][13][14][15] The incidence of undernutrition and overnutrition at diagnosis in children with cancer ranges from 0-65% and 8-30%, respectively, depending on cancer type and methods used to classify nutritional status (NS). 3,12,[15][16][17][18] Children with solid tumors have the highest rates of undernutrition initially in treatment, compared to those with brain tumors and hematological malignancies. 11,15,18 In addition, children with solid tumors may have tumors contributing up to 10% of their body weight, impacting interpretation of weight.…”

“…developed vs. underdeveloped country), duration or type (retrospective vs. prospective), population (size, diagnosis, stage), and standard of nutritional care (SOC). 3,12 Results of nutrition questionnaires, completed by RDNs working with pediatric oncology patients, demonstrate inconsistency in nutrition care, including different nutrition indicators and criteria used for classifying NS, when nutrition assessments (NA) are done and type of nutrition interventions utilized. 13,22,23 Although guidelines have been published for nutrition SOC in the pediatric oncology population, 24,25 it appears that inconsistency persists in both the inpatient and outpatient settings.…”

Malnutrition in paediatric patients with leukaemia and lymphoma: a retrospective cohort study

“…Undernourishment is reported in 6% to 65% of cases in children with cancer and being overweight in 8% to 78%. The prevalence varies depending on the study population [13][14][15][16].…”