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Malnutrition risk and overall survival at solid tumour diagnosis
  1. Tori L. McFarlane1,
  2. James T Symanowski2,
  3. Declan Walsh3,4,
  4. Ye Myint Aung3,
  5. Aynur Aktas3,
  6. Michele L Szafranski3,
  7. Jonathan C Salo5,
  8. Patrick L Meadors3,6 and
  9. Kunal C. Kadakia1,3
  1. 1Department of Solid Tumor Oncology, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Charlotte, North Carolina, USA
  2. 2Department of Biostatistics and Data Sciences, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Charlotte, North Carolina, USA
  3. 3Department of Supportive Oncology, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Charlotte, North Carolina, USA
  4. 4Hemby Family Endowed Chair in Supportive Oncology, Atrium Health Levine Cancer, Charlotte, NC, USA
  5. 5Department of Surgery, Atrium Health Levine Cancer, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Charlotte, North Carolina, USA
  6. 6Health Management Associates, Raleigh, North Carolina, USA
  1. Correspondence to Dr Kunal C. Kadakia; kunal.kadakia{at}atriumhealth.org

Abstract

Purpose Malnutrition severely impacts tolerance to anticancer therapies, but any relationship with overall survival (OS) at the time of solid tumour diagnosis in outpatients in the USA remains unclear.

Methods This retrospective study evaluated 3562 patients who completed the Malnutrition Screening Tool (MST) at diagnosis, identifying the relationship between MST risk, a validated tool evaluating anorexia and weight loss, and OS. MST score of ≥2 of 5 was classified as high malnutrition risk (H-MST). Kaplan-Meier techniques and Cox proportional hazards models were used to analyse OS in H-MST versus low malnutrition risk (L-MST).

Results In the unadjusted models, MST risk was individually associated with OS. Multivariable regression confirmed that MST risk remained independently prognostic for OS after controlling for key confounding variables, HR=1.51 (95% CI: 1.33 to 1.72). The H-MST group had shorter OS (50-month survival rates: 69% L-MST vs 60% H-MST).

Conclusion MST risk at diagnosis is an independent prognostic factor for OS. H-MST risk is associated with shorter survival in a broad cohort of solid tumour oncology outpatients.

  • Cancer
  • Survivorship
  • Supportive care

https://doi.org/10.1136/spcare-2024-004906

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    Footnotes

    • X @AynurAktas12

    • Contributors TLMcF: Manuscript writing, data analysis and interpretation, final approval of manuscript. JTS: Manuscript writing, data analysis and interpretation, final approval of manuscript, conception and design, collection and/or assembly of data. DW: Manuscript writing, data analysis and interpretation, final approval of manuscript, conception and design, provision of study material or patients. YMA: Manuscript writing, data analysis and interpretation, final approval of manuscript. AA: Manuscript writing, data analysis and interpretation, final approval of manuscript. MLS: Manuscript writing, data analysis and interpretation, final approval of manuscript. JCS: Manuscript writing, data analysis and interpretation, final approval of manuscript. PLM: Manuscript writing, data analysis and interpretation, final approval of manuscript, collection and/or assembly of data, provision of study material or patients. KK: Manuscript writing, data analysis and interpretation, final approval of manuscript, conception and design, collection and/or assembly of data. Corresponding Author and Guarantor: KK.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.