Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study

Abstract

// Maurizio Muscaritoli 1 , Simone Lucia 1 , Alessio Farcomeni 2 , Vito Lorusso 3 , Valeria Saracino 3 , Carlo Barone 4 , Francesca Plastino 4 , Stefania Gori 5 , Roberto Magarotto 5 , Giacomo Carteni 6 , Bruno Chiurazzi 6 , Ida Pavese 7 , Luca Marchetti 7 , Vittorina Zagonel 8 , Eleonora Bergo 8 , Giuseppe Tonini 9 , Marco Imperatori 9 , Carmelo Iacono 10 , Luigi Maiorana 10 , Carmine Pinto 11 , Daniela Rubino 11 , Luigi Cavanna 12 , Roberto Di Cicilia 12 , Teresa Gamucci 13 , Silvia Quadrini 13 , Salvatore Palazzo 14 , Stefano Minardi 14 , Marco Merlano 15 , Giuseppe Colucci 16 and Paolo Marchetti 17, 18 , on behalf of the PreMiO Study Group 19 1 Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy 2 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy 3 Department of Medical Oncology, National Cancer Research Centre Giovanni Paolo II, Bari, Italy 4 Department of Medical Oncology, Catholic University of Sacred Heart, Largo A. Gemelli, Rome, Italy 5 Medical Oncology Unit, Ospedale Sacro Cuore Don Calabria, Verona, Italy 6 Oncology Unit, Antonio Cardarelli Hospital, Naples, Italy 7 Oncology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy 8 Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy 9 Department of Oncology, University Campus Bio-Medico of Rome, Rome, Italy 10 Department of Medical Oncology, Azienda Ospedaliera Civile - Maria Paternò Arezzo, Ragusa, Italy 11 Medical Oncology, Clinical Cancer Centre, IRCCS-Arcispedale S. Maria Nuova, Reggio Emilia, Italy 12 Department of Oncology-Hematology, Guglielmo da Saliceto Hospital, Piacenza, Italy 13 Medical Oncology Unit, S.S. Trinita Hospital, Sora, Italy 14 Division of Medical Oncology, Mariano Santo Hospital, Azienda Ospedaliera, Cosenza, Italy 15 Medical Oncology, Oncology Department, S. Croce & Carle Teaching Hospital, Cuneo, Italy 16 Medical Oncology Department, National Cancer Research Centre Giovanni Paolo II, Bari, Italy 17 Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology Sapienza, St. Andrea Hospital, Rome, Italy 18 IDI-IRCCS, Rome, Italy 19 The PreMiO Study group also included investigators who contributed to patients’ enrollment Correspondence to: Maurizio Muscaritoli, email: maurizio.muscaritoli@uniroma1.it Keywords: malnutrition, cancer, cachexia, sarcopenia, oncology Received: April 27, 2017 Accepted: June 20, 2017 Published: August 10, 2017 ABSTRACT Background: In cancer patients, malnutrition is associated with treatment toxicity, complications, reduced physical functioning, and decreased survival. The Prevalence of Malnutrition in Oncology (PreMiO) study identified malnutrition or its risk among cancer patients making their first medical oncology visit. Innovatively, oncologists, not nutritionists, evaluated the nutritional status of the patients in this study. Methods: PreMiO was a prospective, observational study conducted at 22 medical oncology centers across Italy. For inclusion, adult patients (>18 years) had a solid tumor diagnosis, were treatment-naive, and had a life expectancy >3 months. Malnutrition was identified by the Mini Nutritional Assessment (MNA), appetite status with a visual analog scale (VAS), and appetite loss with a modified version of Anorexia-Cachexia Subscale (AC/S-12) of the Functional Assessment of Anorexia-Cachexia Therapy (FAACT). Findings: Of patients enrolled ( N= 1,952), 51% had nutritional impairment; 9% were overtly malnourished, and 43% were at risk for malnutrition. Severity of malnutrition was positively correlated with the stage of cancer. Over 40% of patients were experiencing anorexia, as reported in the VAS and FAACT questionnaire. During the prior six months, 64% of patients lost weight (1–10 kg). Interpretation: Malnutrition, anorexia, and weight loss are common in cancer patients, even at their first visit to a medical oncology center.