Hellenic Journal of Surgery

, Volume 90, Issue 5, pp 246–253 | Cite as

The Prevalence of Malnutrition in Oncology Patients in a Greek General Hospital. Evaluation Using Anthropometric and Laboratory Measurements

  • Eleni PapaefstathiouEmail author
  • K Alexiou
  • Maria Terzopoulou
  • N Sikalias
  • Dimitra Bethani
  • Areti Tsoga
  • N Economou
  • A Lioulias
  • P Pagkratis
  • N Trakas
Original Article


Background and Purpose

The incidence of malnutrition in oncology patients is high, and it depends on the type, location and stage of the tumor and on the treatment. In this empirical study, we aimed to evaluate the prevalence of malnutrition in adults with cancer in a Greek general hospital and to investigate the relationship between objective and subjective nutritional assessment of the patients.


We assessed the nutritional status of 88 oncology patients within 48 hours of admission, using the three nutrition screening tools Subjective Global Assessment (SGA), Nutritional Risk Screening 2002 (NRS 2002) and Malnutrition Screening Tool (MST). The degree of malnutrition was determined using anthropometric measurements and laboratory nutrition-related parameters.


In this Greek hospital, the rate of malnutrition risk in patients with cancer varied, ranging from 35.3% to 45.5%, depending on the nutrition screening tool used. Men, elderly patients and patients with gastric cancer were demonstrated to be at higher risk of malnutrition. Malnourished patients showed significant weight loss, with anorexia being the main gastrointestinal symptom. The objective laboratory nutrition parameters did not always indicate nutritional deficiency, but the anthropometric measurements showed a decrease in these patients.


The problem of malnutrition among Greek oncology patients appears to be significant and there is a need for further efforts in its detection and management.

Key words

Nutritional screening tools oncology patients malnutrition epidemiological study 


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  1. 1.
    Ottery FD. Cancer cachexia: Prevention, early diagnosis and management. Cancer Pract, 1994;2:123–31.Google Scholar
  2. 2.
    Haehling S, Anker SD. Cachexia as a major underestimated and unmet medical need: Facts and numbers. J Cachexia Sarcopenia Muscle 2010;1:159–67.CrossRefGoogle Scholar
  3. 3.
    Carpa S, Ferguson M, Ried K. Cancer: Impact of nutrition intervention outcome-nutrition issues for patients. Nutrition 2001;17:769–72.CrossRefGoogle Scholar
  4. 4.
    Elia M, Zellipour L, Stratton RJ. To screen or not to screen for adult malnutrition? Clin Nut 2005;24:867–84.CrossRefGoogle Scholar
  5. 5.
    Green SM, Watson R. Nutritional screening and assessment tools for use by nurses: literature review. J Adv Nurs 2005;50: 69–83.CrossRefGoogle Scholar
  6. 6.
    Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): A new merthod based on an analysis of controlled clinical trials. Clinical Nutrition 2003;22:321–36.CrossRefGoogle Scholar
  7. 7.
    Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 1987;11:8–13.CrossRefGoogle Scholar
  8. 8.
    Ferguson M, Capra S, Bauer J, et al. Development of a valid and reliable malnutrition screening tool for adult hospital patients. Nutrition 1999;15:458–64.CrossRefGoogle Scholar
  9. 9.
    Mattox TW. Treatment of unintentional weight loss in patients with cancer. Nutr Clin Pract 2005;20:400–10.CrossRefGoogle Scholar
  10. 10.
    Barker L, Gout B, Crowe T. Hospital Malnutrition: Prevalence, identification and impact on patients and the healthcare system. Review Int J Environ Res Public Health 2011;8: 514–27.CrossRefGoogle Scholar
  11. 11.
    Ottery F D. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition 1996;12: S15–19.CrossRefGoogle Scholar
  12. 12.
    Bauer J, Capra S, Ferguson M. Use of the scored patientgenerated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. European journal of Clinical Nutrition 2002;56:779–85.CrossRefGoogle Scholar
  13. 13.
    Leuenberger M, Kurmann S, Stanga Z. Nutritional screening tools in daily clinical practice: The focus on cancer. Support Care Cancer 18 (Suppl 2) 2010;S17–27.Google Scholar
  14. 14.
    Bozzetti F. Screening the nutritional status in oncology: A preliminary report on 1000 outpatients. SCRINIO Working Group. Support Care Cancer 2009;17:279–84.CrossRefGoogle Scholar
  15. 15.
    Raslan M, Gonzalez MC, Torrinhas RSMM, et al. Complementarity of Subjective Global Assessment (SGA) and Nutritional Risk Screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. Clinical Nutrition 2011;30:49–53.CrossRefGoogle Scholar
  16. 16.
    Kyle UG, Kossovsky MP, Karsegard VL, et al. Comparison of tools for nutritional assessment and screening at hospital admission: A population study. Clinical Nutrition 2006;25:409–17.CrossRefGoogle Scholar
  17. 17.
    Laky B, Janda M, Cleghorn G, et al. Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr 2008;87:1678–85.CrossRefGoogle Scholar
  18. 18.
    Velasco C, García E, Rodríguez V, et al. Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: A multicentre study. Eur J Clin Nutr 2011;65:269–74.CrossRefGoogle Scholar
  19. 19.
    Poulia K, Yannakoulia M, Karageorgou D, et al. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clinical Nutrition 2012;31:378–85.CrossRefGoogle Scholar
  20. 20.
    Sarhill N, Mahmoud F, Walsh D, et al. Evaluation of nutritional status in advanced metastatic cancer. Support Care Cancer 2003;11:652–9.CrossRefGoogle Scholar
  21. 21.
    Huhmann MB, Cunningham RS. Importance of nutritional screening in treatment of cancer-related weight loss. Lancet Oncol 2005;6:334–43.CrossRefGoogle Scholar
  22. 22.
    Pressoir M, Desne S, Berchery D, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer 2010;102:966–71.CrossRefGoogle Scholar
  23. 23.
    Donohoe CL, Ryan AM, Reynolds JV. Cancer Cachexia: Mechanisms and clinical implications. Gastroenterol Res Pract 2011;2011:601434. Doi: 10.1155/2011/601434.CrossRefGoogle Scholar
  24. 24.
    Santarpia L, Contaldo F, Pasanisi F. Nutritional screening and early treatment of malnutrition in cancer patients. J Cachexia Sarcopenia Muscle 2011;2:27–35.CrossRefGoogle Scholar
  25. 25.
    Ryu SW, Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients. World J Gastroenterol. 2010;14;16:3310–7.CrossRefGoogle Scholar
  26. 26.
    Kung SP, Tang GJ, Wu CW, et al. Serum albumin concentration as a prognostic indicator for acute surgical patients. Zhonghua Yi Xue Za Zhi (Taipei) 1999;62:61–7.Google Scholar
  27. 27.
    Gholami K, Harirchi I, Abdollahi Lakelayeh M, et al. Nutritional assessment of GI cancer patients at admission and seven days after major intraabdominal surgery. Daru 2006;14:222–8.Google Scholar
  28. 28.
    Gioulbasanis I, Georgoulias P, Vlachostergios P, et al. Mini Nutritional Assessment (MNA) and biochemical markers of cachexia in metastatic lung cancer patients: Interrelations and associations with prognosis. Lung Cancer 2011;74:516–20.CrossRefGoogle Scholar

Copyright information

© Hellenic Surgical Society and Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Eleni Papaefstathiou
    • 1
    Email author
  • K Alexiou
    • 2
  • Maria Terzopoulou
    • 2
  • N Sikalias
    • 5
  • Dimitra Bethani
    • 2
  • Areti Tsoga
    • 6
  • N Economou
    • 2
  • A Lioulias
    • 3
  • P Pagkratis
    • 4
  • N Trakas
    • 1
  1. 1.Department of Clinical ChemistryAthensGreece
  2. 2.Department of SurgeryAthensGreece
  3. 3.Department of Thoracic SurgeryAthensGreece
  4. 4.Department of Hematology“Sismanoglio” General HospitalAthensGreece
  5. 5.Department of SurgeryKalamata General HospitalAthensGreece
  6. 6.Department of Nutrition and BiochemistryAthens School of Public HealthAthensGreece

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