Structured nutritional assessments and interventions maintain nutritional status in patients with advanced cancers

Introduction: Malnutrition frequently occurs in patients with advanced cancers, negatively impacting oncological outcomes. Nutritional support may help counteract cancer-related metabolic alterations and prevent a decline in nutritional status.

Objectives: 1) Evaluation of the impact of structured nutritional interventions on nutritional and metabolic parameters in cancer patients; 2) Investigation of potential interrelationships between these parameters.

Methods: In this prospective study, patients with cancer and malnutrition who received structured nutritional interventions at University Hospital Mannheim between 2023 and 2024 were included. Study visits were conducted at baseline, 1 month and 3 months. Nutritional status was assessed using body weight and bioelectrical impedance analysis to determine phase angle for body composition. Metabolic status was assessed via serum albumin and C-reactive protein (CRP). Nutritional interventions included dietary counseling, oral nutritional supplements, enteral nutrition, parenteral nutrition, or a combination thereof.

Results: A total of 84 patients were enrolled, with a median age of 67.5 years (range, 33-77). Of those, 6 patients (7.1%) had hematological malignancies and 78 (92.9%) had solid tumors, most commonly gastrointestinal cancers (n=57, 67.9%). The majority of patients with solid cancers (n=68, 87.2%) were at advanced tumor stages (UICC III or IV). At baseline, the mean body weight was 73.5±21.4 kg, mean phase angle 4.39±1.09°, mean albumin 30.6±6.7 g/L and median CRP 23.0 mg/l (interquartile range, 5.0 to 56.5). 57 patients (77.0%) received initially oral or enteral nutrition, 9 patients (12.2%) parenteral nutrition, and 8 patients (10.8%) a combination of both.

Over the course of 3 months of nutritional interventions, no significant changes were observed in phase angle (p=0.49), serum albumin (p=0.94), or CRP levels (p=0.19). A significant loss of body weight was detected after 1 month (p=0.01), which subsequently remained stable at 3 months (p=0.90).

Additionally, CRP significantly negatively correlated with phase angle (p=0.001 at baseline, p=0.013 at 1 month and 0.005 at 3 months) and with serum albumin (p<0.0001 at baseline, p<0.001 at 1 month, and 0.005 at 3 months).

Conclusion: Structured nutritional support can help stabilize the nutritional status of patients with advanced cancer. CRP is a useful metabolic marker, correlating with both phase angle and serum albumin.

Präsentiert in der Sitzung: Lebensqualität in der gastrointestinalen Onkologie

Samstag, 20. September 2025, 10:15 – 11:45, Saal 3

 

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Publication History

Article published online:
04 September 2025