Bedeutung des Ernährungsstatus beim Tumorpatienten

Mangelernährung, Sarkopenie und Kachexie

Importance of nutritional status in cancer patients

Malnutrition, sarcopenia, and cachexia

Zusammenfassung

Hintergrund

Gewichts- und Muskelverlust bedrohen häufig Lebensqualität, Abwehrkraft und Prognose onkologischer Patienten. Die Entwicklung und Vergleichbarkeit diagnostischer und therapeutischer Ansätze wurden bisher durch eine Vielzahl unterschiedlicher Einteilungen und Definitionen behindert.

Ziel

In der vorliegenden Arbeit werden typische tumorassoziierte Stoffwechsel- und Ernährungsprobleme strukturiert dargestellt, um so eine Basis für die klinische Diagnostik und Therapie anzubieten.

Ergebnisse

Die Begriffe Mangelernährung, Sarkopenie und Kachexie werden sinnvoll einem generellen Gewichtsverlust, einem spezifischen Muskelmangel und einer erkrankungsassoziierten Mangelernährung zugeordnet. Aktuelle Definitionen internationaler Fachgesellschaften bieten Hoffnung auf bessere Vergleichbarkeit in der klinischen Praxis und bei klinischen Studien.

Schlussfolgerung

Für die tägliche Praxis werden einfache Screening- und differenzierende Diagnoseverfahren empfohlen sowie gezielte Komponenten eines multimodalen Therapiekonzepts aufgeführt.

Abstract

Background

Loss of body weight and of muscle mass endanger quality of life, resilience, and prognosis of cancer patients. The development and comparability of diagnostic and therapeutic approaches up to now have been handicapped by a large number of different and heterogeneous definitions.

Aim

In this article, typical cancer-associated metabolic and nutritional problems are presented in a structured manner to provide a basis for clinical diagnosis and treatment.

Results

The terms malnutrition, sarcopenia, and cachexia are best used to designate unintentional weight loss in general, low muscle mass and function, and disease-associated malnutrition, respectively. Up-to-date definitions of international professional societies offer hope for better comparability in the context of future clinical practice and clinical trials.

Conclusions

Simple screening tools and helpful diagnostic procedures are recommended for daily practice, and components of a targeted multimodal treatment concept are presented.

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Correspondence to Dr. med. Jann Arends.

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Interessenkonflikt

J. Arends und A. Weimann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Arends, J., Weimann, A. Bedeutung des Ernährungsstatus beim Tumorpatienten. Onkologe (2020). https://doi.org/10.1007/s00761-020-00859-7

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Schlüsselwörter

  • Beurteilung der Ernährung
  • Nährstoffbedarf
  • Neoplasien
  • Gewichtsabnahme
  • Nebenwirkungen

Keywords

  • Nutritional assessment
  • Nutritional requirements
  • Neoplasms
  • Weight loss
  • Side effects