Background Knowledge about cancer-related malnutrition and the use of clinical nutrition (CN) in the real-world setting are lacking. We investigated diagnosis and treatment frequency of malnutrition in a multinational survey to identify unmet needs in cancer patients' care. Methods Retrospective analyses were conducted on data from three administrative healthcare datasets from France (n = 570,727), Germany (n = 4642) and Italy (n = 58,468). Data from France described frequency and timing of malnutrition diagnosis in hospitalized gastrointestinal cancer patients. The German data detailed home parenteral nutrition (HPN) use in cancer patients with stage III/IV cancers. The Italian data analysed three cohorts: metastatic with CN, metastatic without CN, and patients without metastatic disease. Results In France, malnutrition diagnosis at first hospitalization occurred in 10% of patients, 13% were subsequently diagnosed, and 77% had no malnutrition diagnosis. In Germany, 16% of patients received HPN. Patients started HPN around 3 months before death. In Italy, 8.4% of metastatic cancer patients received CN; average time between metastasis diagnosis and first CN prescription was 6.6 months. Average time between first CN prescription and death was 3.5 months. Conclusions These data indicate that in the real-world clinical practice, cancer-related malnutrition is under-recognized and undertreated. CN often appears to be prescribed as an end-of-life intervention or is not prescribed at all.Appropriate CN use remains challenging, and current practice may not allow optimal oncologic outcomes for patients at nutritional risk. Improving awareness of malnutrition and generating further evidence on clinical and economic benefits of CN are critical priorities in oncology.

中文翻译：

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肿瘤学临床营养未满足的需求：对现实世界证据的多国分析。

缺乏关于癌症相关营养不良和在现实世界环境中使用临床营养 (CN) 的背景知识。我们在一项跨国调查中调查了营养不良的诊断和治疗频率，以确定癌症患者护理中未满足的需求。方法 对来自法国 (n = 570,727)、德国 (n = 4642) 和意大利 (n = 58,468) 的三个行政医疗保健数据集的数据进行回顾性分析。来自法国的数据描述了住院胃肠癌患者营养不良诊断的频率和时间。德国数据详细介绍了 III/IV 期癌症患者使用家庭肠外营养 (HPN) 的情况。意大利数据分析了三个队列：伴有 CN 的转移性人群、无 CN 的转移性人群和无转移性疾病的患者。结果在法国，10%的患者首次住院时诊断为营养不良，随后诊断为13%，77%未诊断为营养不良。在德国，16% 的患者接受了 HPN。患者在死亡前 3 个月左右开始 HPN。在意大利，8.4% 的转移性癌症患者接受了 CN；从转移诊断到第一次 CN 处方的平均时间为 6.6 个月。第一次 CN 处方与死亡之间的平均时间为 3.5 个月。结论 这些数据表明，在现实世界的临床实践中，与癌症相关的营养不良未被充分认识和治疗。CN 通常被规定为临终干预措施或根本没有规定。适当的 CN 使用仍然具有挑战性，目前的做法可能不允许有营养风险的患者获得最佳的肿瘤学结果。