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Screening the nutritional status in oncology: a preliminary report on 1,000 outpatients

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Abstract

Objective

This study presents the preliminary data of a prospective multi-centre investigation on the screening of the nutritional status of cancer outpatients with the purpose to define: (1) prevalence and rate of weight loss and nutritional risk in this patient population, and (2) to assess the association among some patient-dependent, tumour-dependent and therapy-dependent variables with the nutritional status and the nutritional risk.

Materials and methods

Seventeen centres were involved to collect demographic data (age and sex), oncologic data (site of primary tumour, stage, Eastern Cooperative Oncology Group Performance State, oncologic therapy) and presence and severity of systemic and digestive/nutritional symptoms (fatigue, anorexia, nausea/vomiting, early satiety, dysgeusia/dysosmia, dysphagia/odynophagia, diarrhoea/constipation). Furthermore, the percentage of the weight loss on the usual body weight and the body mass index were computed. The nutritional risk was assessed according to the Nutrition Risk Screening 2002 questionnaire which scores the risk from 0 to 7.

Main results

On the first 1,000 screened patients, a significant weight loss (≥10%) and a nutritional risk score ≥3 were observed in 39.7% and 33.8% of patients, respectively. Weight loss was higher in upper gastrointestinal tumours, in advanced stages of disease and in patients with a poor performance status. Similarly, the nutritional risk was higher in esophageal and pancreatic cancer and in those with a worse performance status. There was a good correlation between the severity of anorexia and the rate of the weight loss The majority of patients with no weight loss or a weight loss <10% were not anorectic; on the contrary, the majority of those with more severe weight loss had some degree of anorexia.

Conclusions

Weight loss and nutritional risk are frequent in an unselected series of cancer outpatients. Site of primary tumour, stage and performance state appear to be associated, at a preliminary analysis, with significant weight loss and nutritional risk. Anorexia and weight loss are closely related, and this supports the concept that nutritional depletion can play a major role in the onset of malnutrition-cachexia.

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Acknowledgements

We thank Novartis (now HealthCare Nestle) Medical Nutrition for the help in collecting data from different centres.

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Authors and Affiliations

  1. Department of Surgery, Hospital of Prato, piazza dell’ Ospedale 5, 59100, Prato, Italy

    Federico Bozzetti

  2. Residenza Le Querce-Milano Due, 20090, Segrate, Italy

    Federico Bozzetti

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on behalf of the SCRINIO Working Group

Corresponding author

Correspondence to Federico Bozzetti.

Appendices

Appendix 1

Table 5 Initial screening
Full size table
Table 6 Final screening
Full size table

Appendix 2

Centres of the SCRINIO Working Group

Asti: LM Amerio (Ospedale Civile)

Belo Horizonte: I Correia (Dept Surgery, University Hospital)

Cagliari: G Mantovani, E Massa, C Madeddu (Dept Medical Oncology, Ospedale Universitario)

Candiolo: L Rovera,R Bianco, P D’Elia (ASO Mauriziano-Presidio IRCC)

Jeddah: SA Eskhi (King Faisal Specialist Hospital & Research Center)

Lucca: M Pellegrini, GR Barsanti, M Battistoni (Presidio Ospedaliero)

Massa Carrara: A Giannoni, G Pennucci (ASL N°1)

Milano: C Gavazzi, C Arcovio, L Licitra, (Fondazione IRCCS Istituto Tumori)

Milano: R Biffi, D Papis, MG Zampino (Istituto Europeo di Oncologia )

Padova: P Magnanimi (Ospedale Civile)

Pavia: R Caccialanza, B Cameletti, S Rocca (Fondazione IRCCS Policlinico San Matteo)

Pinerolo: V Sidoti, GM Rovera (ASL 10 Ospedale Civile)

Prato: F Bozzetti, A DiLeo (Dept Oncology, Ospedale Misericordia e Dolce)

Roma: G Captano, I Pavese, M Tosti (Ospedale San Pietro Fatebenefratelli)

Rozzano : L Cozzaglio (Istituto Clinico Humanitas)

Siena: L DiCosmo (Policlinico Universitario)

Tolmezzo: E Vigevano (Ospedale S Antonio Abbate)

Torino: E Finocchiaro (Ospedale Le Molinette)

Study design and analysis: F Bozzetti (Dept Surgery, Ospedale Misericordia e Dolce, Prato and L Mariani (Unit of Medical Statistics and Biometry, Foundation IRCCS Istituto Tumori, Milano)

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Bozzetti, F., on behalf of the SCRINIO Working Group. Screening the nutritional status in oncology: a preliminary report on 1,000 outpatients. Support Care Cancer 17, 279–284 (2009). https://doi.org/10.1007/s00520-008-0476-3

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  • DOI: https://doi.org/10.1007/s00520-008-0476-3

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