Abstract
Introduction
The majority of cancer patients report malnutrition, with a significant impact on
patient’s outcome. This study aimed to compare how nutritional assessment is conducted
across different surgical oncology sub-specialties.
Methods
Survey modules were designed for breast, hepato-pancreato-biliary (HPB), upper-gastrointestinal
(UGI), sarcoma, peritoneal and surface malignancies (PSM) and colorectal cancer (CRC)
surgeries to describe 4 domains: participants’ setting, evaluation of clinical factors,
use of screening tools and clinical practice. Results were compared among sub-specialties
and according to human development index (HDI) in the largest cohorts.
Results
Out of 457 answers from 377 global participants (62% European), 35.0% were from breast
and 28.9% were from CRC surgeons. Although MDTs management is consistently reported
(64–88%), the presence of a nutritionist/dietician ranges from 14.1% to 44.2%. Breast
surgeons seldom evaluate albumin (25.6%) and weight loss (30.6%), opposite to HPB,
PSM and UGI groups (>70%, p 0.044). Overall, responders declared that the use of screening
tools is largely neglected, that nutritional status is often assessed by the surgeons
and that nutrition is not consistently modified according to risk factors (range among
groups respectively: 1.9%–25.6%, 33.1%–51.4%, 33.1%–60.5%). Less than 20% of breast
surgeons assess patients before/after surgery, comparing to >60% of PSM surgeons.
However, no statistical differences were documented comparing groups for the majority
of the items of the 4 domains. Nutritional evaluation is more often conducted by breast
surgeons in medium/low HDI countries comparing very high/high HDI (p 0.04).
Conclusions
Nutritional assessment is largely neglected. These results identify target-issues
for the implementation of clinical practice.
Keywords
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Article info
Publication history
Published online: September 02, 2020
Accepted:
August 28,
2020
Identification
Copyright
© 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
