Malnutrition, a problem often missed among patients with colorectal cancer, can result in decreased survival. However, its prevalence has not yet been evaluated in our institution. This study aimed to determine the nutritional status among patients with colorectal cancer at the Philippine General Hospital and identify predictors for malnutrition.
A cross-sectional study was conducted among all patients with colorectal cancer seen at the Philippine General Hospital Cancer Institute between December 2019 to February 2020. Anthropometric measurements were taken and nutritional status was evaluated using the Subjective Global Assessment tool. Descriptive statistics, ANOVA and logistic regression were employed to analyze the data.
A total of 292 participants were included in the study with a high prevalence of cachexia (25.34%), sarcopenia (31.16%), and malnutrition (76.37%). Notably, only 17% of patients were referred by oncologists to the dietary service. The presence of liver metastasis and multiple sites of metastases were associated with increasing degree of malnutrition across SGA B and C (p = 0.05). Additionally, more patients with lung and peritoneal metastases were classified as malnourished (p = 0.05). Patients who did not receive chemotherapy, radiation, or surgery were more likely to be malnourished compared to those who previously received or were currently receiving treatment (chemotherapy: p < 0.01; radiation: p = 0.04; surgery: p < 0.01). Furthermore, patients with stage III disease had a higher odds for malnutrition (OR: 6.22, p < 0.01) compared to those with stage I and II disease, while patients who received or were currently receiving chemotherapy were less likely to have malnutrition than those who did not (OR: 0.35, p < 0.01).
Due to the high prevalence of malnutrition among patients with colorectal cancer, routine nutritional evaluation is important. Moreover, the high prevalence of cachexia and sarcopenia warrants early and adequate nutritional intervention. Thus, a hospital-wide program focusing on early nutritional assessment is recommended for implementation.
The authors.
Philippine General Hospital.
All authors have declared no conflicts of interest.