Undernutrition may worsen survival outcomes in cancer patients

Undernutrition appears to reduce overall survival (OS) in patients with cancer, suggests a recent study.

A systematic review and meta-analysis was conducted on studies examining the association between undernutrition, defined by the Patient-Generated Subjective Global Assessment (PG-SGA), and survival outcomes in cancer patients. The investigators retrieved data from the databases of PubMed, Embase, the Cochrane Library, and Web of Science until October 2023.

Eighteen prospective and 14 retrospective studies, including a total of 27,120 cancer patients, met the eligibility criteria. All studies demonstrated high methodological quality, with an average score of 7.66.

Pooled results showed that undernutrition was significantly associated with worse OS (hazard ratio [HR], 1.99, 95 percent confidence interval [CI], 1.62‒2.45). This finding persisted in subgroup analyses, with a pooled HR of 1.64 (95 percent CI, 1.26‒2.13) for moderate undernutrition, which gradually increased to 2.65 (95 percent CI, 2.45‒2.87) in severe undernutrition.

The degree of undernutrition could potentially explain the heterogeneity (p<0.001 for the test of subgroup differences). Sensitivity analyses validated the credibility and robustness of this meta-analysis.

“Detection of nutritional status using the PG-SGA may be beneficial for improving survival in patients with cancer,” the investigators said.

“Undernutrition is prevalent among patients with cancer and may be associated with survival. The PG-SGA is a widely recognized scale for the nutritional assessment of patients with cancer,” they noted.