The risk of malnutrition was common among patients with newly diagnosed gastrointestinal stromal tumors (GISTs), and inadequate nutritional status was correlated with a worse clinical prognosis, according to a new study published in Frontiers in Nutrition.
Around 77.76% of patients with GISTs were at risk for malnutrition, 12.38% of patients had malnutrition, and 2.29% of the patients critically required nutritional support.
“The oppression or obstruction caused by the tumor leads to malabsorption…[resulting] in higher risk of malnutrition,” the authors said. They strongly encouraged correction of nutritional status in patients with newly diagnosed GISTs to improve quality of life and prolong the survival period.
Investigators collected and analyzed data from 1268 patients with newly diagnosed GISTs and determined each patient’s nutritional status using the Nutritional Risk Screening 2002 (NRS2002) and Patient-Generated Subjective Global Assessment (PG-SGA). They assessed the relationship between the PG-SGA score and overall survival rates, as well as factors relating to malnutrition risk.
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Approximately 82.49% (1046) of the patients underwent surgical resection of the tumor while 17.50% (222) underwent neoadjuvant treatment with imatinib. Follow-up for all patients lasted a median of 68.6 months. The 5-year overall survival rate was 74.61% and the median survival time was 42.7 months.
Patients with NRS2002 scores <3 had an overall 5-year survival rate of 79.79%, while the overall 5-year survival rate of patients with NRS2002 scores ≥3 was 73.12%. The 5-year overall survival rate of patients with lower PG-SGA scores of 0-1 and 2-3 were 78.60 and 73.93%, respectively. In contrast, patients with PG-SGA scores higher than 3 had significantly worse overall survival rates (P <.001).
Investigators analyzed the impact of nutritional intervention on prognosis. Patients with PG-SGA scores higher than 4 who received the nutritional intervention had significantly improved survival times compared with those who did not receive the nutritional intervention.
The researchers ascertained that PG-SGA related factors that influenced patient nutritional status included the patients’ age (P =.013), body mass index (P =.001), weight loss (P =.001), anemia (P =.005), tumor location (P =.001), tumor size (P =.002), the National Institutes of Health (NIH) classification (P =.001), pre-albumin levels (P =.010), and albumin levels (P =.002).
Additionally, independent risk factors which affected the 5-year overall survival rate of patients with newly diagnosed GISTs included PG-SGA score (P =.001), NIH classification (P =.000), body mass index (P =.011), pre-albumin (P =.033), and nutritional therapy (P =.012).
One limitation was the retrospective nature of the study using a limited number of cases from one location which affected the generalizability of the research, as well as the data available. The researchers only analyzed overall survival rates.
Ding P, Guo H, Yang P, et al. Association between the nutritional risk and the survival rate in newly diagnosed GIST patients. Frontiers in Nutrition. 2021;8:868. doi:10.3389/fnut.2021.743475