Clinical Research Papers:

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

Maurizio Muscaritoli _, Simone Lucia, Alessio Farcomeni, Vito Lorusso, Valeria Saracino, Carlo Barone, Francesca Plastino, Stefania Gori, Roberto Magarotto, Giacomo Carteni, Bruno Chiurazzi, Ida Pavese, Luca Marchetti, Vittorina Zagonel, Eleonora Bergo, Giuseppe Tonini, Marco Imperatori, Carmelo Iacono, Luigi Maiorana, Carmine Pinto, Daniela Rubino, Luigi Cavanna, Roberto Di Cicilia, Teresa Gamucci, Silvia Quadrini, Salvatore Palazzo, Stefano Minardi, Marco Merlano, Giuseppe Colucci and Paolo Marchetti on behalf of the PreMiO Study Group

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Oncotarget. 2017; 8:79884-79896. https://doi.org/10.18632/oncotarget.20168

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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

Correspondence to:

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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