The performance of three nutritional tools varied in colorectal cancer patients: a retrospective analysis

Abstract

Background and ObjectiveNutritional screening tools should be sensitive, simple, and easy to use. Differing opinions among clinicians concern the simplicity of the three tools—the Global Leadership Initiative on Malnutrition (GLIM) criteria, Nutritional Risk Screening 2002 (NRS-2002), and Patient-Generated Subjective Global Assessment (PG-SGA). For each tool, we estimated prediction of overall survival (OS) in tumor staging, sensitivity, and specificity. The NRS-2002 is favored by clinicians because it is simple to use. We compared its sensitivity and specificity with the GLIM and PG-SGA. Study Design and SettingThis is an analysis of data from 1,358 adult colorectal cancer patients recruited in a multicenter from July 2013 to July 2018. ResultsIn Kaplan–Meier models, each tool was found to be significantly predictive of OS: NRS-2002 (1.28), GLIM (1.49), and PG-SGA (1.42). Use of any tool improved prediction of survival at tumor staging. NRS-2002 has superior specificity (0.90) to diagnose patients without nutritional deficits (GLIM = 0.62 and PG-SGA = 0.82). ConclusionThis study provides evidence for the superiority of NRS-2002 to accurately identify colorectal cancer patients without nutritional limitations. Compared with the complexity of the other tools, NRS-2002 is the simplest tool to use in routine nutritional screening in busy clinical practice.