Preop cancer-related malnutrition depends on cancer type

Editor's Note

Common definitions of malnutrition do not apply to all cancers, and the best approach for surgeons to identify malnourished cancer patients preoperatively is specifically related to the type of cancer the patient has, this study finds.

Of 205,840 major cancer surgical procedures for six different cancers analyzed:

• 16% met criteria for malnutrition—0.6% severe malnutrition; 1% European Society for Parenteral and Enteral Nutrition (ESPEN) 1; 2% ESPEN 2; 6% National Surgical Quality Improvement Program (NSQIP); and 6% mild malnutrition
• 31% were obese
• 54% had normal nutrition status.

Mortality and major morbidity varied significantly between the nutrition groups, including obesity and no malnutrition.

The malnutrition definitions that best predicted postoperative risk differed for the six cancers are:

• colorectal—severe malnutrition
• esophageal—ESPEN 2
• gastric—ESPEN 1
• liver—NSQIP
• lung—ESPEN 1
• pancreatic—ESPEN 1.

These findings can be used to enhance nutritional preparedness preoperatively, the researchers say.