Abstract
Patients with gastrointestinal cancer and malnutrition are less likely to tolerate major surgical procedures, radiotherapy or chemotherapy. In general, they display a higher incidence of complications such as infection, dehiscence and sepsis, which increases the length of stay and risk of death, and reduces quality of life. The aim of this review is to discuss the pros and cons of different points of view to assess nutritional risk in patients with gastrointestinal tract (GIT) tumors and their viability, considering the current understanding and screening approaches in the field. A better combination of anthropometric, laboratory and subjective evaluations is needed in patients with GIT cancer, since malnutrition in these patients is usually much more severe than in those patients with tumors at sites other than the GIT. RESUMO Pacientes com neoplasia gastrointestinal e desnutridos são menos propensos a tolerar procedimentos cirúrgicos de grande porte, radioterapia ou quimioterapia. Em geral, apresentam maior incidência de complicações, como infecção, deiscência e sepse, o que aumenta o tempo de internação e o risco de morte, e reduz a qualidade de vida. O objetivo desta revisão é abordar os prós e contras de diferentes pontos de vista que avaliam risco nutricional em pacientes com tumores do Trato Gastrointestinal (TGI) e sua viabilidade, considerando o atual entendimento e abordagens de triagem neste campo. Melhor combinação de avaliações antropométricas, laboratoriais e subjetivas se faz necessária em pacientes com câncer do TGI, uma vez que a desnutrição nestes pacientes costuma ser muito mais grave do que naqueles indivíduos com tumores em outros sítios que não o TGI.
Highlights
Cancer is a major public health problem worldwide[1]
Malnutrition and subsequent weight loss have long been among the leading causes of morbidity and mortality, as well as increased costs with other organs dysfunction associated to cancer patients undergoing surgery[2]
Patients with gastrointestinal malignancy undergoing major elective procedures have a higher risk of postoperative complications and alterations resulting from their pre and post-admission nutritional status, related to surgical stress, immune suppression induced by cancer or by blood transfusion
Summary
Cancer is a major public health problem worldwide[1]. In addition, malnutrition and subsequent weight loss have long been among the leading causes of morbidity and mortality, as well as increased costs with other organs dysfunction associated to cancer patients undergoing surgery[2]. Patients with gastrointestinal malignancy undergoing major elective procedures have a higher risk of postoperative complications and alterations resulting from their pre and post-admission nutritional status, related to surgical stress, immune suppression induced by cancer or by blood transfusion. Among these factors, malnutrition is the most important due to its high prevalence and negative impact on clinical outcomes such as longer hospital stay[3] and mortality. Health professionals find it difficult to use most of the currently validated tools for nutritional assessment, due to limited time, method reproducibility, organization or cost[6,7,8]. The objective of this review is to present an overview of the methods and tools used to determine nutritional risk, considering the pros and cons when applied to patients with GIT cancer
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