JPEN J Parenter Enteral Nutr. 2022 Nov 12. doi: 10.1002/jpen.2463. Online ahead of print.
ABSTRACT
BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition has been associated with cancer mortality, while the effect is limited and inconsistent. We performed this meta-analysis aiming to assess this relationship in patients with cancer.
METHODS: We systematically searched Embase, PubMed, Web of Science, Cochrane, CINAHL, CNKI, Wanfang and VIP databases from 1 January 2019 to 1 July 2022. Studies evaluating the prognostic effect of GLIM-defined malnutrition on cancer survival were included. A fix-effect model was fitted to estimate the combined hazard ratio (HR) with 95% confidence interval (CI). Heterogeneity of studies was analyzed using the I2 statistic. Quality assessment were performed using the Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.
RESULTS: The search strategy identified 4378 articles in all databases combined. Nine studies (8829 patients) met the inclusion criteria were included for quantitative analysis. Meta-analysis revealed significant associations between the GLIM-defined pooled malnutrition (HR=1.75, 95%CI=1.43 to 2.15), moderate malnutrition (HR=1.44, 95%CI=1.29 to 1.62) and severe malnutrition (HR=1.79, 95%CI=1.58 to 2.02) with all-cause mortality. Sensitivity analysis supported the robustness of these associations. The between-study heterogeneity was low (all I2 < 50 %) and study quality assessed with NOS was high (all scores > 6). The evidence quality by the GRADE tool was very low.
CONCLUSIONS: Our meta-analysis suggests a significant negative association of malnutrition, as defined by the GLIM, with overall survival in patients with cancer. However, definitive conclusions cannot be precluded due to the low quality of the source data. This article is protected by copyright. All rights reserved.
PMID:36371641 | DOI:10.1002/jpen.2463
