Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: secondary analysis of a prospective randomized trial

Bargetzi, Laura; Brack, Christine; Herrmann, Joerg; Bargetzi, Annika; Hersberger, Lara; Bargetzi, Mario; Kaegi-Braun, Nina; Tribolet, Pascal; Gomes, Filomena; Hoess, Claus; Pavlíček, V.; Bilz, Stefan; Sigrist, Sarah; Brändle, Michael; Henzen, Christoph; Thomann, Robert V.; Rutishauser, Jonas; Aujesky, Drahomir; Rodondi, Nicolas; Donzé, Jacques; Laviano, Alessandro; Stanga, Zeno; Müeller, Beat; Schuetz, Philipp

doi:10.1016/j.annonc.2021.05.793

Cited by 103 publications

(70 citation statements)

References 49 publications

(70 reference statements)

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“…A previous study had shown that 20% of elderly cancer patients with malnutrition were obese. BMI was found to be a less valid screening tool for determining malnutrition in elderly patients with cancer (22).In addition, the use of individualized nutritional support is recommended in elderly patients with cancer who are already malnourished or are at a risk of becoming malnourished (23). These patients are predisposed to age-related sarcopenia and reduced gastrointestinal absorption (24).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

et al. 2021

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Background: Malnutrition is common in patients with cancer and is associated with adverse outcomes, but few data exist in elderly patients. The aim of this study was to report the prevalence of malnutrition using three different scoring systems and to examine the possible clinical relationship and prognostic consequence of malnutrition in elderly patients with cancer.Methods: Nutritional status was assessed by using controlling nutritional status (CONUT), the prognostic nutritional index (PNI), and the nutritional risk index (NRI). Quality-of-life (Qol) was assessed during admission by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Performance status (PS) was assessed by using the Eastern Cooperative Oncology Group (ECOG) classification. The relationship between nutritional status and overall survival and Qol were examined.Results: Data were available for 1,494 elderly patients with cancer (63.65% male), the mean age was 70.76 years. According to the CONUT, NRI, and PNI, 55.02, 58.70, and 11.65% patients were diagnosed with malnutrition, respectively. Worse nutritional status was related to older, lower BMI, lower hand grip strength, and more advanced tumor stage. All malnutrition indexes were correlated with each other (CONUT vs. PNI, r = −0.657; CONUT vs. NRI scores, r = −0.672; PNI vs. NRI scores, r = 0.716, all P < 0.001). During a median follow-up of 43.1 months, 692 (46.32%) patients died. For patients malnourished, the incidence rate (events-per-1,000person-years) was as follows: CONUT (254.18), PNI (429.91), and NRI (261.87). Malnutrition was associated with increased risk for all-cause mortality (adjust HR [95%CI] for CONUT: 1.09 [1.05–1.13], P < 0.001; PNI: 0.98[0.97–0.99], P < 0.001; NRI: 0.98 [0.98–0.99], P < 0.001). All malnutrition indexes improved the predictive ability of the TNM classification system for all-cause mortality. Deterioration of nutritional status was associated with deterioration in Qol parameters and immunotherapeutic response (P < 0.001).Conclusions: Malnutrition was prevalent in elderly patients with cancer, regardless of the assessment tools used, and associated with lower Qol and the immunotherapy response.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

et al. 2021

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“…It was approved by the ethics committee of Northwestern Switzerland (EKNZ; 2014_001) and was registered at ClinicalTrials.gov in August 2015 ( https://clinicaltrials.gov/ct2/show/NCT02517476 ). The trial protocol, 14 the main results 10 as well as results regarding long-term outcomes, 15 cost outcomes 16 and results of secondary analyses 12 , 13 , 17 , 18 , 19 , 20 , 21 , 22 have been published previously. All patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial

et al. 2022

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“…Malnutrition in patients with cancer is associated with incremental mortality and morbidity, extended length of hospital stays (LOS), and poorer quality of life (5)(6)(7). Studies have revealed that individualized nutritional support reduces the risk of mortality and improves the function and quality of life among the patients with cancer with higher nutritional risk, relative to when they were provided only with hospital nutrition (8). Nevertheless, the nutritional risk screening must be performed first from the time of cancer diagnosis, and patients with abnormal screening should undergo nutritional assessment before deciding whether to use nutritional therapy (9,10).…”

Section: Introductionmentioning

confidence: 99%

Influence of Malnutrition According to the GLIM Criteria on the Clinical Outcomes of Hospitalized Patients With Cancer

Liu

et al. 2021

Front. Nutr.

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Background: Malnutrition is prevalent among patients with cancer. The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing malnutrition in 2019. The objectives of this study were to assess the prevalence of malnutrition in patients with cancer using the GLIM criteria, explore the correlation between the GLIM criteria, and clinical outcomes, and compare the GLIM criteria with subjective global assessment (SGA).Methods: This retrospective analysis was conducted on 2,388 patients with cancer enrolled in a multicenter study. Nutritional risk was screened using the Nutritional Risk Screening-2002, and the nutritional status was assessed using SGA and GLIM criteria. Chi-square analysis and Wilcoxon rank sum test, stratified by age 65 years, were used to evaluate the effect of GLIM-defined malnutrition on clinical outcomes. Logistic regression analysis was used to analyze the nutritional status and complications, and the interrater reliability was measured using a kappa test.Results: The prevalence of malnutrition defined by the GLIM criteria was 38.9% (929/2,388). GLIM-defined malnutrition was significantly associated with in-hospital mortality (P = 0.001) and length of hospital stays (P = 0.001). Multivariate logistic regression analysis showed GLIM-defined malnutrition significantly increased complications (odds ratio [OR] 1.716, 95% CI 1.227–2.400, P = 0.002). The GLIM criteria had a “moderate agreement” (kappa = 0.426) compared with the SGA.Conclusions: The prevalence of malnutrition in hospitalized patients with cancer is high, and malnourishment in patients with cancer is associated with poorer clinical outcomes. The use of the GLIM criteria in assessing the nutritional status of inpatients with cancer is recommended and can be used as the basis for nutritional interventions.

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Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: secondary analysis of a prospective randomized trial

Abstract: Nutritional support during the hospital stay reduces mortality in patients with different types of cancers: Secondary analysis of a prospective randomized trial Annals of Oncology (2021), doi:

Cited by 103 publications

References 49 publications

Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial

Influence of Malnutrition According to the GLIM Criteria on the Clinical Outcomes of Hospitalized Patients With Cancer

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