Malnutrition and overall survival in older patients with cancer

Clin Nutr. 2021 Mar;40(3):966-977. doi: 10.1016/j.clnu.2020.06.026. Epub 2020 Jul 1.


Background & aims: In this study, we assessed the prevalence of malnutrition and its association with overall survival among patients with cancer aged 65 years and older.

Methods: In this retrospective cohort study, patients receiving cancer care underwent a comprehensive geriatric assessment (CGA). Malnutrition status was determined through the CGA. We used univariate and multivariable Cox regression survival analyses to assess the association between baseline malnutrition and survival.

Results: A total of 454 patients with cancers were included in the analysis. The median age was 78 years and men and women were equally represented. Forty-two percent (n = 190) were malnourished at baseline, and 33% died during the follow-up (range 0.2-51.1 month). Univariate analysis showed that malnutrition increased the risk of all-cause mortality in older patients with cancer (HR, 1.49; 95% CI, 1.08-2.05; p = 0.01). In the multivariate Cox regression model, malnutrition increased the risk of all-cause mortality (HR, 1.87; 95% CI, 1.10-3.17; p = 0.02) in older patients with solid tumors. However, malnutrition did not increase the risk of all-cause mortality for hematologic malignancies.

Conclusions: In our study, we found that malnutrition was a risk factor for mortality in older cancer patients, especially in older patients with solid tumors. Prospective inter ventional studies are recommended.

Keywords: Cancer care; Cancer survivorship; Geriatric; Malnutrition; Mortality; Weight loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Malnutrition / etiology
  • Malnutrition / mortality*
  • Neoplasms / complications
  • Neoplasms / mortality*
  • Nutrition Assessment
  • Nutritional Status
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis