Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 10;8(45):79884-79896.
doi: 10.18632/oncotarget.20168. eCollection 2017 Oct 3.

Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study

Maurizio Muscaritoli  1 , Simone Lucia  1 , Alessio Farcomeni  2 , Vito Lorusso  3 , Valeria Saracino  3 , Carlo Barone  4 , Francesca Plastino  4 , Stefania Gori  5 , Roberto Magarotto  5 , Giacomo Carteni  6 , Bruno Chiurazzi  6 , Ida Pavese  7 , Luca Marchetti  7 , Vittorina Zagonel  8 , Eleonora Bergo  8 , Giuseppe Tonini  9 , Marco Imperatori  9 , Carmelo Iacono  10 , Luigi Maiorana  10 , Carmine Pinto  11 , Daniela Rubino  11 , Luigi Cavanna  12 , Roberto Di Cicilia  12 , Teresa Gamucci  13 , Silvia Quadrini  13 , Salvatore Palazzo  14 , Stefano Minardi  14 , Marco Merlano  15 , Giuseppe Colucci  16 , Paolo Marchetti  17   18 ; PreMiO Study Group
Affiliations

Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study

Maurizio Muscaritoli et al. Oncotarget. .

Abstract

Background: In cancer patients, malnutrition is associated with treatment toxicity, complications, reduced physical functioning, and decreased survival. The Prevalence of Malnutrition in Oncology (PreMiO) study identified malnutrition or its risk among cancer patients making their first medical oncology visit. Innovatively, oncologists, not nutritionists, evaluated the nutritional status of the patients in this study.

Methods: PreMiO was a prospective, observational study conducted at 22 medical oncology centers across Italy. For inclusion, adult patients (>18 years) had a solid tumor diagnosis, were treatment-naive, and had a life expectancy >3 months. Malnutrition was identified by the Mini Nutritional Assessment (MNA), appetite status with a visual analog scale (VAS), and appetite loss with a modified version of Anorexia-Cachexia Subscale (AC/S-12) of the Functional Assessment of Anorexia-Cachexia Therapy (FAACT).

Findings: Of patients enrolled (N=1,952), 51% had nutritional impairment; 9% were overtly malnourished, and 43% were at risk for malnutrition. Severity of malnutrition was positively correlated with the stage of cancer. Over 40% of patients were experiencing anorexia, as reported in the VAS and FAACT questionnaire. During the prior six months, 64% of patients lost weight (1-10 kg).

Interpretation: Malnutrition, anorexia, and weight loss are common in cancer patients, even at their first visit to a medical oncology center.

Keywords: cachexia; cancer; malnutrition; oncology; sarcopenia.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST None of the authors declares any conflict of interest which might have interfered with conducting the present study and with the interpretation of the results.

Figures

Figure 1
Figure 1. Causes and consequences of malnutrition in cancer: anorexia, cachexia, and sarcopenia
Figure 2
Figure 2
PreMiO patients with malnutrition or malnutrition risk using MNA scoring with results shown by tumor stage and for all tumors (A) as well as classified in M0 and M1 groups (B) (N=1925). P<0.001 among cancer stage groups. Malnutrition was defined as MNA score <17, while risk of malnutrition was represented by MNA scores of 17 to 23.5. M0 = stage I-III, M1 = stage IV.
Figure 3
Figure 3. Prevalence of overt malnutrition by cancer site (% of patients with specified tumor type), with malnutrition defined as MNA score <17 (N=1925)
M0 = stage I-III, M1 = stage IV. P<0.001 among cancer site groups.
Figure 4
Figure 4. Prevalence of cachexia by primary tumor type in the study population (N=1952)
Cachexia is defined by weight loss >5% or by the dual criteria of BMI <20 with weight loss of 2% to 5%. M0 = stage I-III, M1 = stage IV. P<0.001 among cancer site groups.
Figure 5
Figure 5. Prevalence of pre-cachexia by cancer site, as determined by percent of patients with unintentional weight loss up to 5% during prior 6 months, along with chronic systemic inflammation and anorexia-related symptoms (N=1085)
M0 = stage I-III, M1 = stage IV. P<0.05 among cancer site groups.
Figure 6
Figure 6. Prevalence of systemic inflammation by cancer site, as determined by % patients with elevated blood levels of C-reactive protein (N=1087)
M0 = stage I-III, M1 = stage IV. P<0.001 among cancer site groups.
See this image and copyright information in PMC

References

    1. Maasberg S, Knappe-Drzikova B, Vonderbeck D, Jann H, Weylandt KH, Grieser C, Pascher A, Schefold JC, Pavel M, Wiedenmann B, Sturm A, Pape UF. Malnutrition predicts clinical outcome in patients with neuroendocrine neoplasias. Neuroendocrinology. 2017;104:11–25. - PubMed
    1. Attar A, Malka D, Sabate JM, Bonnetain F, Lecomte T, Aparicio T, Locher C, Laharie D, Ezenfis J, Taieb J. Malnutrition is high and underestimated during chemotherapy in gastrointestinal cancer: an AGEO prospective cross-sectional multicenter study. Nutr Cancer. 2012;64:535–542. - PubMed
    1. Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr. 2014;38:196–204. - PubMed
    1. Pressoir M, Desne S, Berchery D, Rossignol G, Poiree B, Meslier M, Traversier S, Vittot M, Simon M, Gekiere JP, Meuric J, Serot F, Falewee MN, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer. 2010;102:966–971. - PMC - PubMed
    1. Planas M, Alvarez-Hernandez J, Leon-Sanz M, Celaya-Perez S, Araujo K, Garcia de Lorenzo A, PREDyCES® researchers Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer. 2016;24:429–435. - PubMed

LinkOut - more resources