The relationship between systemic inflammation, body composition and clinical outcomes in patients with operable colorectal cancer at low and medium to high nutritional risk.

T Abbas,P.G Horgan,D.C Mcmillan,R.D Dolan

doi:10.1016/j.clnesp.2020.09.483

Abstract

Rationale: In accordance with ESPEN (European Society of Parenteral and Enteral Nutrition) guidelines, the combination of malnutrition screening tool (MUST)1, systemic inflammation (mGPS) and body composition (SMI and SMD) were examined in relation to clinical outcomes in patients undergoing surgery for colorectal cancer (CRC).

Highlights

Cancer is a leading cause of death worldwide
Compared with low malnutrition universal screening tool (MUST), moderate to high MUST was associated with older age (P < 0.001), female sex (P < 0.05), higher American Society of Anaesthesiologist (ASA) (P < 0.01), emergency presentation (P < 0.001), colon cancer (P < 0.01), higher modified Glasgow prognostic score (mGPS) (P < 0.001) and neutrophil lymphocyte ratio (NLR) (P < 0.001), lower subcutaneous and visceral obesity, low skeletal muscle index (SMI) (P < 0.001), low skeletal muscle density (SMD) (P < 0.05), longer hospital stay (P < 0.001) and poorer 3 year survival (P < 0.001)
Compared with mGPS 0, mGPS 1/2 was associated with higher ASA (P < 0.01), higher NLR (P < 0.001), low SMI (P < 0.001), low SMD (P < 0.01), greater length of hospital stay (P < 0.001), and poorer 3 year survival (P < 0.05)

Summary

Introduction

Cancer is a leading cause of death worldwide. Colorectal cancer (CRC) is the third most common cancer and is the fourth leading cause of cancer related deaths worldwide. Various nutritional assessment methods are routinely used and, in the UK, malnutrition universal screening tool (MUST) has been adopted by the British Association of Parenteral and Enteral Nutrition.[4] MUST score is a five-step process to categorize patients in low, medium, and high nutritional risk groups as shown in Figure 1 and in accordance with international nutritional guidelines.[5] MUST score is widely used in National Health Service in the UK, and nursing and medical staff are familiar with its use and is included in the admission checklist. Society of Parenteral and Enteral Nutrition guidelines, the combination of malnutrition universal screening tool (MUST), systemic inflammation [modified Glasgow prognostic score (mGPS)] and body composition [skeletal muscle index (SMI) and skeletal muscle density (SMD)] were examined in relation to clinical outcomes in patients undergoing surgery for colorectal cancer (CRC).

Objectives

Methods

Results

Conclusion