(PTFS06-01-24) The Association of Malnutrition Risk With All-Cause Mortality Across Cancer Types

Objectives: Studies investigating the association of malnutrition with mortality in cancer patients is sparse and primarily restricted to head and neck and digestive cancers. Yet, malnutrition risk factors (e.g., advanced age, late-stage cancer diagnosis, side effects of treatment) are experienced across cancer types. Our objective was to evaluate the association of malnutrition risk with all-cause mortality among oncology patients treated at the Huntsman Cancer Institute (HCI).

Methods: Malnutrition risk was measured using the validated Malnutrition Screening Tool (MST) implemented as standard of care at outpatient HCI clinics (highest MST score within one year of cancer diagnosis). Data were abstracted from Electronic Medical Records. Cox proportional hazards regression was used to assess the association of malnutrition risk (MST score ≥2 versus < 2) with time to death from any cause among all cancer patients. The underlying time metric was days from cancer diagnosis to event. A secondary analysis stratified by cancer type was carried out if sample size was adequate. Models were adjusted for age at diagnosis, sex, race, marital status, smoking status, cancer stage, body mass index at diagnosis, and cancer treatment type.

Results: 1891 patients were included. 22% of patients screened at risk for malnutrition (MST score ≥2). Participants were aged 62±15 years, 48% were female, and most were white (86%). Malnutrition risk was associated with increased risk of all-cause mortality for all cancer patients combined (HR 1.65, 95% CI 1.29-2.12). For specific cancers, malnutrition risk was significantly associated with mortality among patients with digestive (HR 1.74, 95% CI 1.15-2.65) and hematologic cancers (HR 8.02, 95% CI 2.06-31.19). Respiratory (HR 1.37, 95% CI 0.84-2.22) and head and neck cancers (HR 1.64, 95% CI 0.81-3.31) showed positive associations that did not reach statistical significance.

Conclusions: Malnutrition risk was associated with elevated risk of mortality for all cancers combined and specific cancer types, including some that have received limited attention in prior research. These results highlight the importance of addressing malnutrition in cancer patient prognosis.

Funding Sources: Funded by the Huntsman Cancer Institute FY23 Cancer Control and Population Sciences Program Grant