Nutritional Status Of Cancer Patients Research Articles

Role of albumin and prealbumin in assessing nutritional status and predicting increased risk of infectious complications during childhood cancer treatment

IntroductionProper nutrition in patients with cancer is important for preventing treatment complications and achieving remission. Malnutrition in these patients leads to reduced production of essential structural proteins.PurposeThe aim of the study was to assess the role of albumin and prealbumin in assessing the nutritional status of cancer patients and in predicting an increased risk of infectious complications during treatment.Patients and MethodsThe study included 40 pediatric patients with newly diagnosed cancer and 30 healthy children serving as controls. Prealbumin, albumin, and C-reactive protein (CRP) levels and the upper arm muscle area (UAMA) were measured before and after treatment in children with cancer and compared with the control group to evaluate nutritional status. Additionally, we assessed associations between these parameters and the incidence of infectious complications during cancer treatment in patients with anthropometric malnutrition, as well as associations with an increased risk of malnutrition related to inflammation before treatment.ResultsAt baseline, patients with cancer had lower prealbumin and albumin levels (p< 0.001), higher CRP levels (p < 0.001), and lower UAMA percentiles (p = 0.0245) compared with controls. Cancer treatment resulted in an increase in prealbumin and albumin levels (p < 0.001) and a reduction in CRP levels (p < 0.001), with no change in UAMA (p = 1.000). Prealbumin deficiency was more common than albumin deficiency before and after cancer treatment. Median prealbumin and albumin levels tended to increase with an increasing UAMA percentile range, but these differences were not significant (p> 0.05). The incidence of infectious complications during treatment in patients with risk factors for inflammation-related malnutrition was similar to that in patients with pre-existing anthropometric malnutrition without inflammation (p = 1.000). In a univariable logistic regression model including prealbumin and albumin deficiency, as well as low UAMA percentile, albumin deficiency before treatment was shown to be a significant predictor of 3 or more infectious episodes during treatment (p = 0.02).ConclusionAlbumin and prealbumin deficiency may predict the risk of malnutrition associated with inflammation in patients with cancer. Hypoalbuminemia may predict an unfavorable course of treatment complicated by frequent infections in these patients.

Poor nutrition doubles post-COVID-19 syndrome risk in cancer patients: insights from a Chinese multicentre study

BackgroundSince 2019, approximately 760 million SARS-CoV-2 cases have been reported globally, with post-COVID-19 syndrome posing significant challenges for cancer patients due to their immunosuppressed status and poor nutritional conditions. The role of nutritional status in influencing their infection risk and post-COVID-19 outcomes remains unclear, underscoring the need for targeted research and strategies.ObjectiveTo investigate the impact of baseline nutritional status on SARS-CoV-2 infection and the risk of post-COVID-19 syndrome in cancer patients.MethodsA multicenter cross-sectional study was conducted from December 2022 to June 2023 in four tertiary hospitals across China. Cancer inpatients aged 18 years and older were enrolled and classified into two groups based on their Nutritional Risk Screening (NRS) scores. The correlation between SARS-CoV-2 infection, post-COVID-19 syndrome and nutritional status were analyzed using multivariable logistic regression.ResultsAmong 834 eligible cancer patients, 10.8% were in the high nutritional risk group (NRS ≥ 3). The prevalence of SARS-CoV-2 infection was 58.8% (95% confidence interval, CI: 56.8–60.8%), and post-COVID-19 syndrome was 21.0% (95% CI: 10.4–14.4%). After adjusting for confounding factors, the high nutritional risk group had a significantly higher prevalence of post-COVID-19 syndrome compared to the low nutritional risk group (32.7% vs. 19.5%, AOR: 2.37, 95% CI: 1.23–4.54, p = 0.010). However, no significant difference in SARS-CoV-2 infection rates was found between the two groups (61.1% vs. 58.5%, AOR: 1.12, 95% CI: 0.70–1.80; p = 0.634).InterpretationPoor baseline nutritional status in cancer patients is associated with a higher prevalence of post-COVID-19 syndrome, providing preliminary information on post-COVID-19 syndrome in this population. These findings underscore the importance of adequate nutritional management in cancer patients, particularly during pandemic recurrences.

Effects of nutritional interventions on cancer patients receiving neoadjuvant chemoradiotherapy: a meta-analysis of randomized controlled trials.

Malnutrition commonly occurs in cancer patients, impacting their quality of life and survival duration. The objective of this meta-analysis and systematic review is to assess the effects of nutritional interventions on patients undergoing neoadjuvant chemoradiotherapy. A comprehensive search was conducted in PubMed, Embase, and the Cochrane Library databases to obtain randomized controlled trials of nutritional interventions in patients with neoadjuvant chemoradiotherapy. Outcomes assessed included toxicity reactions to neoadjuvant therapy, levels of inflammation-related markers, nutritional status, and relevant clinical outcomes. The relative risk (RR) or weighted mean difference (WMD) and 95% confidence interval (CI) were used as effect sizes. A total of 16 studies were included, involving 954 patients. Nutritional intervention significantly reduced the incidence of vomiting (RR = 0.37, 95%CI: 0.21-0.67, P = 0.001) and mucositis (RR = 0.82, 95%CI: 0.67-1.00, P = 0.046) in patients with neoadjuvant chemoradiotherapy. For the nutritional status of cancer patients, nutritional intervention significantly increased the proportion of well-nourished patients (RR = 12.74, 95%CI: 4.43-36.69, P < 0.001). In addition, nutritional intervention also reduced the length of hospital stay in neoadjuvant chemoradiotherapy patients after surgery (WMD = - 0.82, 95%CI: - 1.61- - 0.02, P = 0.043). However, there was no improvement in nausea (P = 0.534), diarrhea (P = 0.068), febrile neutropenia (P = 0.551), levels of albumin (P = 0.211), prealbumin (P = 0.063), C-reactive protein (P = 0.430), clinical remission (P = 0.148), or postoperative complications (P = 0.098). Nutritional intervention can reduce the toxicity of neoadjuvant chemoradiotherapy (vomiting and mucositis), improve the nutritional status of patients, and shorten the length of postoperative hospital stay. Well-designed and high-quality studies are necessary to confirm the effect of nutritional interventions on cancer patients, with a specific focus on reaching nutritional goals and providing the right nutrients.

Tab-Cox: An Interpretable Deep Survival Analysis Model for Patients With Nasopharyngeal Carcinoma Based on TabNet.

The nutritional status of cancer patients is closely associated with the clinical progression of the disease. A survival analysis model combined with a neural network can predict future disease trends in patients, facilitating early prevention and assisting physicians in making diagnoses. However, the complexity of neural networks and their incompatibility with medical tabular data can reduce the interpretability of the model. To address this issue, thr paper propose a novel survival analysis model called Tab-Cox, which combines TabNet and Cox models. This model is specifically designed to predict the survival outcomes of patients with nasopharyngeal carcinoma. The model utilizes TabNet's sequential attention mechanism to extract more interpretable features, providing an interpretable method for identifying disease risk factors. Consequently, the model ensures accurate survival prediction while also making the results more comprehensible for both patients and doctors. The paper tested the efficacy of the model by conducting experiments on various diverse datasets in comparison with other commonly used survival models. The results showed that the proposed model delivered the highest or second-highest accuracy across all datasets. Furthermore, the paper conducted a comparative interpretability analysis against the classical Cox model. In addition and compare the interpretability of the Tab-Cox model with the classical Cox model and discuss the advantages and disadvantages of its interpretability. This demonstrates that Tab-Cox can assist doctors in identifying risk factors that are challenging to capture using artificial methods.

Preoperative nutritional assessment by using subjective and objective criteria and its implication in the outcome of cancer patients undergoing abdomino-pelvic surgeries

The World Health Organization (WHO) defines “nutritional status” as the condition of the body resulting from the intake, absorption, and utilization of nutrients and the influence of particular physiological and pathological status.[1] Globally, malnutrition affects a significant proportion of individuals, with prevalence rates ranging from 30% to 85%, particularly prevalent among patients with gastric, pancreatic, lung, prostate, and colon cancers.[2] In cancer patients, malnutrition is associated with decreased treatment tolerance, increased postoperative morbidity and mortality, and diminished quality of life [3]The evaluation of nutritional status in cancer patients commonly relies on subjective methods such as the Patient-Generated Subjective Global Assessment (PG-SGA)[4] and objective measures like anthropometry and biochemical parameters[5]. Despite their widespread use, no single method is universally accepted as the "gold standard," each possessing its’ inherent limitations.

Prevalence of Malnutrition and Influence of an Individualized Nutritional Support on the Nutritional Status of Cancer Patients

Background: Muscle mass loss, impaired dietary intake, and poor nutritional status are hallmarks of patients with cancer. Cancer-associated malnutrition can lead to several negative consequences, including poor prognosis, reduced survival, increased therapy toxicity, reduced tolerance and compliance to treatment, and diminished response to drugs. The main aim of this study is to understand the prevalence of malnutrition using Global Leadership Initiative on Malnutrition Criteria (GLIM Criteria) and evaluate the impact of tailor-made nutritional intervention on the nutritional status of patients with cancer. Methods and Material: An interventional prospective study was conducted among 100 adult hospitalized cancer patients. The study was based on the Nutrition Care Process model, where nutritional assessment was done using GLIM criteria and Malnutrition Universal Screening Tool (MUST), and muscle mass was assessed using the Handgrip Dynamometer. Nutritional diagnosis was made based on assessment; nutritional intervention was provided through Individualized Nutritional Counseling &amp; Oral Nutritional Support, and nutritional monitoring was done for patients during their stay in hospital using 24-hour daily dietary recall. Nutritional evaluation was done at the time of discharge using GLIM criteria, MUST, and Handgrip Strength (HGS). Data analysis was done using SPSS v24 statistical software (developed by IBM) to find out the Mean and Standard Deviation. Paired t test, Chi-square test, and Regression Analysis were used to analyze the qualitative variables. Statistical significance was defined as P &lt; 0.05. Results: The current study evaluated 100 participants among whom 26% of participants were malnourished as assessed by MUST and 22% participants had poor muscle strength. A paired t-test was performed and it was found that the calorie intake (1504.1 ± 158.7) and the protein intake (56.08±7.01) were almost double after the nutrition intervention. The difference was found to be highly statistically significant with P &lt; 0.01. Thus, nutrition intervention significantly (P &lt; 0.01) improved calorie and protein intake. The overall mean MUST score at baseline was 0.39 which was reduced significantly (P &lt; 0.000) to 0.17 at the end of the study. The HGS improved significantly (P &lt; 0.000) from 10.02 to 25.51 after the nutrition intervention and it was evidenced by 2.5 times increase in HGS (25.51 ± 2.40) by the end of the study. Conclusion: Individualized nutritional support with continuous monitoring and counseling resulted in improvement in nutritional status as evidenced through their improved MUST score and HGS.

Association of the modified Glasgow prognostic score and prognostic nutritional index with duration of oral anamorelin administration in patients with cancer cachexia: a retrospective cohort study.

The modified Glasgow Prognostic Score (mGPS) and Prognostic Nutritional Index (PNI) are indicators of nutritional status in cancer patients; however, the effects of baseline mGPS and PNI on the duration of administration of the ghrelin receptor agonist anamorelin, which is used to treat cachexia in patients with cancer, are unclear. This study aimed to clarify the association of mGPS and PNI with the duration of oral anamorelin administration for patients who did not have beneficial effects from anamorelin. The attending physician determined the duration of oral anamorelin administration based on discontinuation due to cancer progression, poor efficacy, adverse events, or death. The 12-week continuation rate of oral anamorelin was 30.4%. Univariate analysis revealed that an Eastern Cooperative Oncology Group performance status (ECOG-PS) of ≥2 (P<.001), concurrent chemotherapy (P=.002), albumin level (P=.005), C-reactive protein level (P=.013), and a mGPS of 2 (P=.014) were statistically significant predictors of the 12-week continuation rate of oral anamorelin. In the multivariate analysis, a mGPS of 2 remained a significant risk factor, and the ECOG-PS and concurrent chemotherapy had no effect on the association between the mGPS and 12-week continuation rate of oral anamorelin. Patients with a mGPS of 2, compared with mGPS of 0 or 1, are less likely to maintain oral anamorelin therapy, regardless of the ECOG-PS or concurrent chemotherapy. Therefore, it is necessary to consider initiating anamorelin administration at mGPS 0 or 1.

A Cross Sectional Study to Assess the Nutritional Status of Cancer Patients in A Tertiary Care Facility in Meghalaya, Northeast India

A Cross Sectional Study to Assess the Nutritional Status of Cancer Patients in A Tertiary Care Facility in Meghalaya, Northeast India

Instruments for Evaluating the Nutritional Status of Cancer Patients Undergoing Antineoplastic Treatment: A Scoping Review.

The use of validated tools to evaluate the nutritional status of the cancer patient provides guaranteed precision and reliability in their nutritional evaluation, ensuring that the information is accurate and reflects the patient's situation. The aim of this study was to identify the valid and reliable instruments in the evaluation of the nutritional status of cancer patients with a diagnosis of solid tumor undergoing antineoplastic treatment (chemotherapy and/or immunotherapy). A scoping review was conducted to search for original articles published in scientific journals in English, Spanish, or Portuguese in the past five years. In order to identify potentially relevant documents, searches were performed in the following databases: SCOPUS, WOS, CINAHL, MEDLINE, BVS, and PUBMED. DECS-MeSH descriptors and Boolean operators were used. In addition, the Arksey and O'Malley protocol, the Joanne Briggs Institute (JBI) method, and the flow chart of the Preferred Information Elements for Systematic Reviews and Meta-Analyses, known as PRISMA, were followed. The initial search strategy identified a total of 164 references, which were examined successively, leaving a final selection of ten studies. It was found that the most used instrument for nutritional evaluation was the Patient-Generated Subjective Global Assessment (PG-SGA). Other questionnaires also stood out such as the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening (NRS 2002), and the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The variation in the tools used ranges from subjective assessments to objective measurements, thus underlining the need for a comprehensive and individualized approach.

Development and validation of a risk prediction model for community-acquired pressure injury in a cancer population: A case-control study

BackgroundPatients with cancer are susceptible to pressure injuries, which accelerate deterioration and death. In patients with post-acute cancer, the risk of pressure injury is ignored in home or community settings. ObjectiveTo develop and validate a community-acquired pressure injury risk prediction model for cancer patients. MethodsAll research data were extracted from the hospital's electronic medical record system. The identification of optimal predictors is based on least absolute shrinkage and selection operator regression analysis combined with clinical judgment. The performance of the model was evaluated by drawing a receiver operating characteristic curve and calculating the area under the curve (AUC), calibration analysis and decision curve analysis. The model was used for internal and external validation, and was presented as a nomogram. ResultsIn total, 6257 participants were recruited for this study. Age, malnutrition, chronic respiratory failure, body mass index, and activities of daily living scores were identified as the final predictors. The AUC of the model in the training and validation set was 0.87 (95 % confidence interval [CI], 0.85–0.89), 0.88 (95 % CI, 0.85–0.91), respectively. The model demonstrated acceptable calibration and clinical benefits. ConclusionsComorbidities in patients with cancer are closely related to the etiology of pressure injury, and can be used to predict the risk of pressure injury. Implications for practiceThis study provides a tool to predict the risk of pressure injury for cancer patients. This suggests that improving the respiratory function and nutritional status of cancer patients may reduce the risk of community-acquired pressure injury.

The Impact of Chemotherapy on Nutritional Status

Introduction: A state of malnutrition is so commonly associated with tumor disease that it is often considered an integral part of the evolution of cancers. Materials and Methods: This is a prospective monocentric study carried out in the Medical Oncology department of the PHE of Laghouat. Patients with cancer and followed in this service between October 4, 2020 and November 26, 2020 have been included. The main objective was to study the impact of chemotherapy on the nutritional status of cancer patients by assessing the nutritional status and quantifying its anthropometric and biological parameters. Malnutrition is defined as weight loss &gt; 5% in one month or &gt; 10% in six months and/or body mass index ≤ 18,5 kg/m² and/or albuminemia 30 g/L in adult patients aged &lt; 70 and by weight loss 5% in one month or 10% in six months and/or body mass index ≤ 21 kg/m² and/or albuminemia 35 g/L in patients aged ≥70. Results: This study included 123 patients with a sex ratio of 0.6 and an average age of 51.81±14.33 years who were sectioned into 2 groups: undernutrition with a weight loss greater than 5% of usual weight and or BMI 18, 5kg/m² and or albuminemia 30g/L (in 70-year-old patients) and or BMI21 kg/m² and or albuminemia 35g/L (in 70-year-old patients) (n=16, 13%) and those without malnutrition (n=107, 87%). Men accounted for 34.6% of the not undernourished population and 56.3% of the malnourished population. The weight change in the undernourished group was on average -1.12%±5.4 with 30.1% of undernourished people have PDP&gt;5% and 81.26% were on chemotherapy. The mean BMI of the undernourished population is 18.63kg/m² 3.98 and the mean albumin is 35.65 3.68 g/L in the undernourished population. Discussion and Conclusion: The undernutrition of cancer patients is common and associated with less benefit from chemotherapy and a derogatory prognosis.

A Subjective Assessment of Chemotherapy Drug-Induced Taste and Smell Alteration in Non-head and Neck Cancer Patients: A Questionnaire-Based Cross-Sectional Study.

This study aimed to evaluate alterations in taste and smell perceptions among non-head and neck cancer patients receiving chemotherapy, aiming to identify factors influencing these changes. A cohort of 70 non-head and neck cancer patients undergoing one to four cycles or more than four cycles, over a six-month period, from oncology outpatient clinics was recruited. Participants completed structured taste and smell questionnaires with assistance from interviewers. Demographic data, recurrence history, chemotherapy cycles, drug regimens, and taste and smell perceptions were analyzed using descriptive statistics and chi-square tests. The mean age of participants was 46.5 years, with a predominance of females (81.4%) and breast cancer cases (42.9%). Taste changes were more prevalent (62.9%) than smell changes (32.9%) post chemotherapy, particularly among those on combination drug regimens. Salty taste alterations were the most common (30.0%), followed by sweet taste (22.9%)and sour/bitter tastes (14.3%). Moreover, 38.57% of patients reported experiencing dysgeusia, while 30% noted the occurrence of parosmia post chemotherapy. Chemotherapy-induced alterations in taste and smell significantly impact the quality of life and nutritional status of cancer patients. Despite often being overlooked, these changes warrant increased attention in oncological practice to inform treatment decisions and enhance symptom management, particularly in palliative care settings. Further research is needed to explore the implications of chemosensory alterations on patient outcomes and treatment strategies.

Nutrition therapy in colorectal cancer patient with severe malnutrition: A case report

Background: Malnutrition in cancer patients generally, and in gastrointestinal cancer specifically, is common, that could be from the cancer itself or the treatment. Thus, it is necessary to follow special nutrition rules in patients with colorectal cancer. This study aims to see the progress of the nutritional status of cancer patients treated with special nutrition rules. Case Description: A 72-year-old man was brought to the ER with the chief complaint of weakness, felt since 1 week ago. Other complaints are loss of appetite and liquid stool. History of weight loss is 12 kg in the last 6 months. He was diagnosed with colorectal cancer 6 months ago. The patient looks pale, with conjunctiva pallor, loss of subcutaneous fat in arms, trunk, and feet, and loss of muscle in the face, ribs, and shoulder. He was then admitted to the ward with a diagnosis of colorectal cancer with severe malnutrition. Nutrition therapy has been given since the beginning. The total energy was 2,100 kkal, with 80gr protein, 280gr carbohydrate, and 70gr fat. The patient was treated for 10 days. Clinically improved: the conjunctiva was no more pallor, arm circumference increased to 19cm, he had gained his appetite, was no longer dripping with norepinephrine, and no longer needed O2 supplementation (SaO2 in room air: 98%). Conclusion: Cancer treatment causes side effects on nutrition status. It is essential to give special nutrition rules to patients with colorectal cancer. Cancer patients also suffer from inadequate food intake, reduced ability to digest food, and disturbed body homeostasis. Malnutrition, especially in cancer patients, could result in general weakening, lower immunity, prolonged recovery period, and lower tolerance to the side effects of cancer therapy. Early nutrition therapy has a good impact on the nutritional status of the cancer patient.

Assessment of Nutritional Status and Correlation of Factors With Body Mass Index of Cancer Patients: A Cross-Sectional Study.

Decreased diet intake and malnourishment have profound implications on cancer patients' quality of life and survival. Malnutrition increases the risk of postoperative complications, increases hospital length stays, reduces patient's tolerance to radiation and chemotherapy treatment, and results in poor response to treatment. In the present study, we intended to assess the nutritional status of cancer patients and find the correlation of body mass index with anthropometric and blood parameters. The study was prospective and cross-sectional, and 104 patients with newly diagnosed solid tumors were included. Patient demographics, symptoms, and anthropometric and blood parameters were collected. The correlation was estimated with Pearson's correlation coefficient. A p-value of less than 0.05 was considered significant. The association between stages of the disease, dental status, type of diet, and BMI was p=0.701, 0.216, and 0.422, respectively, and was not statistically significant. The anthropometric parameters mid upper arm circumference (MUAC cm), mid arm circumference (MAC cm), and triceps skinfold thickness (TSF mm) correlated with body mass index (BMI kg/m2) and had statistically significant p values of 0.0001, 0.0001, and 0.033, respectively. The correlation was assessed between hemoglobin, red cell distribution width, neutrophil-to-lymphocyte ratio, and serum albumin levels with BMI, but except for albumin (p=0.05), no other blood parameter correlated. Nutritional assessment is vital in recognizing patients at risk of treatment-associated complications and poor responders to treatment. In this study, BMI correlated with anthropometric parameters MUAC, MAMC, and TSF. Baseline dietary assessments of patients will help focus on the nutritional build-up of patients before starting treatment.

Assessment of the Nutritional Status of Cancer Patients in Qena Governorate

Assessment of the Nutritional Status of Cancer Patients in Qena Governorate

Evaluation of Nutritional Status in Cancer Patients Underwent Radiotherapy: The Results of Biochemical, Body Composition with Bioelectrical Impedance Analysis, Anthropometric Measurements, and Patient-Generated Subjective Global Assessment

Aim: This study aims to evaluate the nutritional status and the effect of radiotherapy (RT) on nutrition in all ambulatory cancer patients. Material and Method: In this prospective observational study 105 cancer patients with various diagnoses treated between 2013 and 2014 were evaluated. All patients were ≥18 years old and had Karnofsky Performance Status ≥70. Anthropometric measurements, body composition with bioelectric impedance, and patient-generated Subjective Global Assessment (PG-SGA) tools were used. The height, weight, body mass index (BMI), triceps skin fold thickness, mid-upper arm circumference, hemoglobin, and serum albumin levels were determined twice before and after RT. Additionally, nutrition-related symptoms and short-term weight loss results were determined by PG-SGA questionnaires. Results: The patients’ median age was 53 years (range, 18-82 years). At initial evaluation 74 patients were well nourished using the PG-SGA global rating. Malnutrition developed in totally 33 of these 74 patients after RT. The PG-SGA results after RT were significantly worse than before treatment. PG-SGA revealed no significant relationship between nutritional status prior to RT and the parameters including gender, age, mean weight, BMI, disease duration, pre-RT hemoglobin and albumin levels. Post-RT evaluation showed a significant relationship between deterioration (PG-SGA B-C) and mean weight, BMI, serum albumin, hemoglobin levels, and concomitant chemotherapy. Gastrointestinal and head and neck cancer patients had the most deterioration after RT. The patients' weight, BMI, fat-free mass, total body water, and the percentage weight loss at the end of RT were significantly lower than the initial assessment. Conclusion: It is considerable to use multiple tools for nutritional monitoring. Patients who received RT to the head and neck and upper abdomen region had a high risk of deterioration after treatment. These patients should be monitored carefully during all treatment periods.

Sipping as a Nutritional Supplement in Ambulatory Palliative Oncology Care: A Pilot Study with Noninvasive Methods.

Objective: The implementation of nutritional support is a basic need of patients in palliative oncological care. This pilot study optimized the use of sipping to improve the nutritional status of cancer patients in palliative care. Materials and Method: The pilot study included 63 patients, 61.3 years of age on average (range: 32-82 years of age). The patients were assigned to either group A (no nutritional support n = 39 patients) or group B (sipping as nutritional support n = 24 patients). The patients were evaluated through by noninvasive methods: body weight, waist and arm circumference, and triceps skinfold, bioimpedance analysis, and dynamometry. Quality of life was assessed through modified questionnaires. Results: In contrast with group A, group B did not have a significant weight loss, that is, A: 81.9 ± 15.8-80.5 ± 15.8 kg (P = .028) and B: 73.9 ± 14.9-73 ± 16 kg. Body mass index A: 29 ± 5-28.5 ± 5 kg/m2 (P = .007) and B: 25.3 ± 4.7-25 ± 4.9 kg/m2 (P = .614). Waist circumference A: 93.5 ± 15.1-92.5 ± 14.8 cm (P = .008) and B: 80.1 ± 13.2-80.6 ± 12.3 cm (P = .234). Triceps skinfold A: 12.3 ± 7.2-11 ± 6.7 mm (P = .001) and B: 8.2 ± 6.1-7.9 ± 5.7 mm (P = .207). Fat free mass A: 54.8 ± 11.5-52.8 ± 11.6 kg (P = .018) and B: 54.7 ± 10.9-52.8 ± 11.5 kg (P = .207). Significantly lower dynamometer values were recorded in both groups; A: 25.6 ± 10.4-23.1 ± 10.3 kg (P = .010) and B: 27.4 ± 9.9-24.3 ± 9.1 kg (P = .009). In contrast to group B, the patients in group A showed slight variations in their health status, thus decreasing their scores into the significance limit (P = .072). Conclusion: Our results suggest that providing nutritional support in the form of sipping (∼12 g proteins, 300 kcal) on a daily basis prevents the loss of active tissue mass in palliative oncology patients. Based on these results, we recommend the inclusion of this simple nutritional support to prevent malnutrition in cancer patients in palliative care. The clinical study was registered by the internal ethics committee under the heading of its approval - Institutional Ethics Committee of the Hradec Králové Faculty Hospital, number 201311S2OP.

Identifying and Addressing Nutritional Inequities and Psychosocial Needs of Cancer Patients Residing in Zip-Code Designated Food Priority Areas (FPAs)

Nutrition is an essential aspect of cancer care at all time points leading to and after definitive therapy. Yet, cancer patients who reside in FPAs may experience limited access to healthy meals, possibly affecting cancer outcomes. There is no prospective data evaluating the consequence of residing in FPAs as it relates to perceived nutritional access, psychosocial needs, or nutritional status of cancer patients before, during, and after definitive treatment. Therefore, this study aims to characterize the nutritional needs of cancer patients undergoing curative radiation treatment (RT). We hypothesize that FPA residence will correlate with perceived lack of access to healthy food as well as other unmet psychosocial cancer needs at multiple time points during care. Under IRB approval, a prospective, cross-sectional analysis was done using a questionnaire consolidated from previously validated surveys assessing the nutritional and psychosocial needs of patients with curable lung, head/neck, gynecological, or gastrointestinal cancers at different time points of cancer care (pre-treatment, 1 month, 6 months, and 1 year after completion of RT). Groups were compared using Χ2 and Mann-Whitney U tests as appropriate. Binary logistic regression was used to identify predictors of healthy food access. From May 2019 to December 2022, 320 of 434 patients completed the survey, giving a compliance rate of 74%. Twenty-six percent of patients resided in zip-code designated FPAs. Patients who lived in FPAs were more likely to self-identify as black (60.5% vs 39.5%; p<0.001), single (p<0.001), have a lower median income (p<0.001), and were more likely to receive care at our inner-city photon therapy center (p<0.001) compared to non-FPA residents. Compared with non-FPA patients, the cohort who lived in FPAs had higher unmet nutritional needs (p = 0.003), which included a greater demand for healthier ways to eat (67.6%vs.54.4; p = 0.047) and a greater concern of having inadequate funds to buy healthy meals (44.4%vs.19.9%; p = 0.002). On MVA, marital status, median income, race, educational level and FPA residence were included, however only black race (OR:8.85; 95% CI:3.73-16.32; p<0.001) and education level (Elementary School: OR:8.32; 95% CI:1.19-58.33; p = 0.001, REF: Graduate/Professional) were predictors for nutritious meals uncertainty. Inequities in nutritional needs were clearly identified in patients residing in FPAs when compared to non-FPA patients. Race and educational level are important factors in identifying patients in need of nutritional support. These demographics along with FPA-designated zip codes can be used to identify at-risk patients during clinic visits, where continuous nutritional and psychosocial support can be provided.

Factors Associated With Malnutrition in Hospitalized Cancer Patients in a National Oncology Center in Conflict-Affected Settings in Sana'a, Yemen: An Institution-Based Cross-Sectional Study.

Background Cancer can significantly impact thenutritional statusof patients, which can worsen related complications and reduce the effectiveness of treatment. Malnutrition is a common complication among cancer patients, especially among older adults. This study aims to determine the prevalence of malnutrition amonghospitalized cancer patientsand identify factors associated with malnutrition. Methodology and methods The cross-sectional descriptive study was performed on 296 cancer patients admitted to the National Oncology Referral Center in Sana'a, Yemen, between February 1 and March 31, 2022. Malnutrition was diagnosed through clinical assessment andscreening toolssuch as screening tools, body mass index (BMI),weight loss percentage, and mid-upper arm circumference (MUAC).Descriptive statistics, chi-square, andmultivariable logistic regression analysiswere used to assess factors associated with malnutrition. Results Of the 296 patients included in the analysis, most were female 225 (76.0%), and the mean age was 45.8 years. The prevalence of undernutrition, as determined by the BMI score, was 48 (16.2%). The prevalence of malnutrition was higher in females 37 (16.4%) compared to males 11(15.5%). The data indicated that 49% of hospitalized patients had experienced weight loss of 5% or more. Multivariable logistic regression analysis showed that single (AOR=12.93, 95% CI: 1.17-142.77) or widowed (AOR=11.51, 95% CI: 1.05-126.03) marital status,weight loss (AOR=7.56, 95% CI: 3.00-18.69), stomach cancer (AOR=6.77, 95% CI: 1.66-27.70), andbreast cancer(AOR=2.60, 95% CI: 1.12-6.03) were associated with an increased risk of malnutrition. Conclusions The study highlights the importance of evaluating and addressing the nutritional status of cancer patients, especially at the beginning and during treatment, to improve their clinical outcomes. Prospective studies are recommended to further investigate this issue.

Influence of body composition assessment with bioelectrical impedance vector analysis in cancer patients undergoing surgery.

Malnutrition is common in patients undergoing surgery for cancers and is a risk factor for postoperative outcomes. Body composition provides information for precise nutrition intervention in perioperative period for improving patients' postoperative outcomes. The aim was to determine changes in parameters of body composition and nutritional status of cancer patients during perioperative period. A total of 92 patients diagnosed with cancer were divided into gastrointestinal and non-gastrointestinal cancer group according to different cancer types. The patients body composition assessed by bioelectrical impedance vector analysis (BIVA) on the day before surgery, postoperative day 1 and 1 day before discharge. The changes between two groups were compared and the correlation between body composition and preoperative serum nutritional indexes was analyzed. The nutritional status of all patients become worse after surgery, and phase angle (PA) continued to decrease in the perioperative period. Fat-free mass (FFM), fat-free mass index (FFMI), skeletal muscle mass (SMM), extracellular water (ECW), total body water (TBW), hydration, and body cell mass (BCM) rise slightly and then fall in the postoperative period in patients with gastrointestinal cancer, and had a sustained increase in non-gastrointestinal patients, respectively (P<0.05). Postoperative body composition changes in patients with gastrointestinal cancer are related to preoperative albumin, pre-albumin, hemoglobin, and C-reactive protein (P<0.05), whereas postoperative body composition changes in patients with non-gastrointestinal cancer are related to age (P<0.05). Significant changes in body composition both in patients with gastrointestinal cancer and non-gastrointestinal cancer during perioperative period are observed. Changes in body composition for the cancer patients who undergoing surgery are related to age and preoperative serum nutrition index.