Clinical Research Papers:
Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study
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Maurizio Muscaritoli1, Simone Lucia1, Alessio Farcomeni2, Vito Lorusso3, Valeria Saracino3, Carlo Barone4, Francesca Plastino4, Stefania Gori5, Roberto Magarotto5, Giacomo Carteni6, Bruno Chiurazzi6, Ida Pavese7, Luca Marchetti7, Vittorina Zagonel8, Eleonora Bergo8, Giuseppe Tonini9, Marco Imperatori9, Carmelo Iacono10, Luigi Maiorana10, Carmine Pinto11, Daniela Rubino11, Luigi Cavanna12, Roberto Di Cicilia12, Teresa Gamucci13, Silvia Quadrini13, Salvatore Palazzo14, Stefano Minardi14, Marco Merlano15, Giuseppe Colucci16 and Paolo Marchetti17,18, on behalf of the PreMiO Study Group19
1Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
2Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
3Department of Medical Oncology, National Cancer Research Centre Giovanni Paolo II, Bari, Italy
4Department of Medical Oncology, Catholic University of Sacred Heart, Largo A. Gemelli, Rome, Italy
5Medical Oncology Unit, Ospedale Sacro Cuore Don Calabria, Verona, Italy
6Oncology Unit, Antonio Cardarelli Hospital, Naples, Italy
7Oncology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy
8Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
9Department of Oncology, University Campus Bio-Medico of Rome, Rome, Italy
10Department of Medical Oncology, Azienda Ospedaliera Civile - Maria Paternò Arezzo, Ragusa, Italy
11Medical Oncology, Clinical Cancer Centre, IRCCS-Arcispedale S. Maria Nuova, Reggio Emilia, Italy
12Department of Oncology-Hematology, Guglielmo da Saliceto Hospital, Piacenza, Italy
13Medical Oncology Unit, S.S. Trinita Hospital, Sora, Italy
14Division of Medical Oncology, Mariano Santo Hospital, Azienda Ospedaliera, Cosenza, Italy
15Medical Oncology, Oncology Department, S. Croce & Carle Teaching Hospital, Cuneo, Italy
16Medical Oncology Department, National Cancer Research Centre Giovanni Paolo II, Bari, Italy
17Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology Sapienza, St. Andrea Hospital, Rome, Italy
18IDI-IRCCS, Rome, Italy
19The PreMiO Study group also included investigators who contributed to patients’ enrollment
Maurizio Muscaritoli, email: [email protected]
Keywords: malnutrition, cancer, cachexia, sarcopenia, oncology
Received: April 27, 2017 Accepted: June 20, 2017 Published: August 10, 2017
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.
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