Role of nutritional status in predicting quality of life outcomes in cancer – a systematic review of the epidemiological literature

Abstract

Malnutrition is a significant factor in predicting cancer patients’ quality of life (QoL). We systematically reviewed the literature on the role of nutritional status in predicting QoL in cancer. We searched MEDLINE database using the terms “nutritional status” in combination with “quality of life” together with “cancer”. Human studies published in English, having nutritional status as one of the predictor variables, and QoL as one of the outcome measures were included. Of the 26 included studies, 6 investigated head and neck cancer, 8 gastrointestinal, 1 lung, 1 gynecologic and 10 heterogeneous cancers. 24 studies concluded that better nutritional status was associated with better QoL, 1 study showed that better nutritional status was associated with better QoL only in high-risk patients, while 1 study concluded that there was no association between nutritional status and QoL. Nutritional status is a strong predictor of QoL in cancer patients. We recommend that more providers implement the American Society of Parenteral and Enteral Nutrition (ASPEN) guidelines for oncology patients, which includes nutritional screening, nutritional assessment and intervention as appropriate. Correcting malnutrition may improve QoL in cancer patients, an important outcome of interest to cancer patients, their caregivers, and families.

Bioelectrical Impedance Phase Angle as a Prognostic Indicator of Survival in Head-and-Neck Cancer

“…In a systematic review, Lis et al 6 found an association between weight loss and swelling. In patients with advanced hnc who undergo surgery, lymph node stage, non-radical resection margins, and occurrence of major postoperative complications have been demonstrated to affect disease-specific survival in men and women alike.…”

“…The obstacles to weight maintenance result not only from the cancer itself but also from its therapy: surgery, radiotherapy, and chemotherapy, which also lead to additional complications (for example, in oral intake) 2,5 . The incidence of malnutrition in cancer patients ranges between 40% and 80%, and the prevalence ranges from 50% to 80% depending on tumour type, tumour location, stage of disease, treatment received, and the nutrition assessment method used 6 . Malnutrition and nutrition deficits all have a significant effect on mortality, morbidity, and quality of life in patients with hnc [7][8][9][10] .…”

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

“…It is a multidimensional concept which addresses various areas related to physical, emotional, sexual and functioning (Victorson et al, 2007). A systematic review demonstrated a strong association between nutritional status and health related quality of life in the cancer population (Lis et al, 2012).…”

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

“…It is not surprising that weight loss has a negative impact on QoL, considering loss of muscle mass (sarcopenia) is a major cause of fatigue (81,82) and weight loss is associated with reduced functional ability (78) . Nutrition-related symptoms associated with chemotherapy such as nausea, vomiting, fatigue and constipation negatively impact the patients' wellbeing, thus reducing their QoL (83,84) . Appetite loss and fatigue, could be a cause or a consequence of malnutrition in cancer patients and lead to subsequent deterioration in global health status and functional scales, which might result in dose-limiting toxicities or suspension of chemotherapy treatment, and ultimately increased morbidity and mortality (7,64,85,86) .…”