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Cited by 23Nutrition and Health in AgingClinical Nutrition and GastroenterologyBody Composition Measurement Techniques

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Oncology-Led Early Identification of Nutritional Risk: A Pragmatic, Evidence-Based Protocol (PRONTO)

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Muscaritoli, Maurizio, Bar-Sela, Gil, Battisti, Nicolo Matteo Luca, Belev, Borislav, Contreras-Martínez, Jorge, Cortesi, Enrico, de Brito-Ashurst, Ione, Prado, Carla M., Ravasco, Paula, Yalcin, Suayib·2023·Cancers
DOI 10.3390/cancers15020380PMC PMC9856655
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Abstract

Nutritional issues, including malnutrition, low muscle mass, sarcopenia (i.e., low muscle mass and strength), and cachexia (i.e., weight loss characterized by a continuous decline in skeletal muscle mass, with or without fat loss), are commonly experienced by patients with cancer at all stages of disease. Cancer cachexia may be associated with poor nutritional status and can compromise a patient’s ability to tolerate antineoplastic therapy, increase the likelihood of post-surgical complications, and impact long-term outcomes including survival, quality of life, and function. One of the primary nutritional problems these patients experience is malnutrition, of which muscle depletion represents a clinically relevant feature. There have been recent calls for nutritional screening, assessment, treatment, and monitoring as a consistent component of care for all patients diagnosed with cancer. To achieve this, there is a need for a standardized approach to enable oncologists to identify patients commencing and undergoing antineoplastic therapy who are or who may be at risk of malnutrition and/or muscle depletion. This approach should not replace existing tools used in the dietitian’s role, but rather give the oncologist a simple nutritional protocol for optimization of the patient care pathway where this is needed. Given the considerable time constraints in day-to-day oncology practice, any such approach must be simple and quick to implement so that oncologists can flag individual patients for further evaluation and follow-up with appropriate members of the multidisciplinary care team. To enable the rapid and routine identification of patients with or at risk of malnutrition and/or muscle depletion, an expert panel of nutrition specialists and practicing oncologists developed the PROtocol for NuTritional risk in Oncology (PRONTO). The protocol enables the rapid identification of patients with or at risk of malnutrition and/or muscle depletion and provides guidance on next steps. The protocol is adaptable to multiple settings and countries, which makes implementation feasible by oncologists and may optimize patient outcomes. We advise the use of this protocol in countries/clinical scenarios where a specialized approach to nutrition assessment and care is not available.

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  • Two nutritional screening tools for both conditions have been recently published, Remote-Malnutrition APP (R-MAPP) and PROtocol for NuTritional risk in Oncology (PRONTO).

    “Similarly, two nutritional screening tools for both conditions have been recently published, Remote—Malnutrition APP (R-MAPP) and PROtocol for NuTritional risk in Oncology (PRONTO) (55, 56).”

    From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [56]

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Metadata

Authors
Muscaritoli, M., Bar-Sela, G., Battisti, N. M. L., Belev, B., Contreras-Martínez, J., Cortesi, E., de Brito-Ashurst, I., Prado, C. M., Ravasco, P., & Yalcin, S.
Affiliations
  • Sapienza University of Rome (IT)
  • Oncology Department, Emek Medical Center, Afula 1834111, Israel
  • The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK
  • University Hospital Centre Zagreb (HR)
  • Hospital Regional de Malaga, 29010 Malaga, Spain
  • Royal Marsden NHS Foundation Trust (GB)
  • University of Alberta (CA)
  • Universidade Católica Portuguesa (PT)
  • Department of Medical Oncology, Institute of Cancer, Hacettepe University, Ankara 06800, Turkey
Corresponding author
Muscaritoli, Maurizio
ORCID
Venue
Cancers
Publisher
MDPI AG
Published
2023-01-06
Volume
15
Issue
2
Pages
380
ISSN
2072-6694 (ISSN-L)
DOI
10.3390/cancers15020380
PMC
PMC9856655
OpenAlex
W4313827487
Cited by
23
References
2
Citations by year
2026: 8 · 2025: 6 · 2024: 8 · 2023: 1
FWCI
4.08
Type
journal article
Language
en
Open access
Licence
Locations
  • Cancers (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by)
Funders
Abbott
Topics
  • Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
Keywords
cancer-related malnutrition, nutritional risk screening, sarcopenia, cachexia, antineoplastic therapy, multidisciplinary care

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