Introduction

Multiple screening methods for malnutrition are available, but a systematic review of evidence in patients with colorectal cancer (CRC) is lacking. The aim of this study is to systematically investigate which outcome variables of nutritional screening methods are associated with treatment tolerance in patients with CRC.

Material and Methods

A systematic review was performed with respect to outcome variables of nutritional screening methods and their association with systemic treatment tolerance in patients with CRC. The Cochrane guidelines for systematic reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Two authors independently assessed the risk of bias and quality of each included study.

Results

A total of sixteen studies were included. The following screening methods for malnutrition were assessed in the included studies: serum albumin, body mass index, C-reactive protein/albumin ratio, modified version of the Glasgow prognostic score, mini nutritional assessment, nutritional risk index, patient-generated subjective global assessment, sarcopenia and weight loss.

Discussion

Sarcopenia tended to be associated with treatment tolerance more often than other screening methods but the current review suggests that there are ample screening methods rendering meaningful outcomes regarding a patient's nutritional status and associated risk for treatment intolerance. This grants practitioners the flexibility to choose from a variety of different nutritional screening methods. Nutritional screening can thus be tailored to the individual patient. Importantly, nutritional screening may help identify those patients at risk for chemotoxicity thus allowing for the implementation of targeted prehabilitation programs in order to prevent (severe) chemotoxicity.

中文翻译：

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结直肠癌患者营养筛查方法的结果变量与全身治疗耐受性之间的关联：系统评价

介绍

有多种营养不良筛查方法可用，但缺乏对结直肠癌 (CRC) 患者证据的系统评价。本研究的目的是系统地研究营养筛查方法的哪些结果变量与 CRC 患者的治疗耐受性相关。

材料与方法

对营养筛查方法的结果变量及其与 CRC 患者全身治疗耐受性的关联进行了系统评价。遵循系统评价的 Cochrane 指南和系统评价和荟萃分析 (PRISMA) 指南的首选报告项目。两位作者独立评估了每项纳入研究的偏倚风险和质量。

结果

总共包括 16 项研究。在纳入的研究中评估了以下营养不良筛查方法：血清白蛋白、体重指数、C 反应蛋白/白蛋白比值、改良版格拉斯哥预后评分、迷你营养评估、营养风险指数、患者主观整体评估，肌肉减少症和体重减轻。

讨论

与其他筛查方法相比，肌肉减少症往往与治疗耐受性相关，但目前的审查表明，有足够的筛查方法可以提供有关患者营养状况和治疗不耐受相关风险的有意义的结果。这使从业者可以灵活地从各种不同的营养筛查方法中进行选择。因此，可以针对个体患者量身定制营养筛查。重要的是，营养筛查可能有助于识别那些有化学毒性风险的患者，从而允许实施有针对性的预康复计划，以防止（严重的）化学毒性。