Undernutrition in elderly patients with cancer: target for diagnosis and intervention.

In recent years, geriatricians and oncologists have worked together to evaluate elderly patients with cancer before and during treatment, to estimate the balance between the efficacy and safety of chemotherapy and to upgrade treatment in this population according to their comorbidity and physiological status. The clinical and biological factors of this population need to be assessed in multidisciplinary comprehensive geriatric assessment (CGA) in order to optimize treatment without inducing major adverse effects. We reviewed the nutritional aspects of this evaluation that highlight the impact of undernutrition on poor survival. In this paper we briefly describe tumoral cachexia (molecular and physiological), the impact of undernutrition on cancer prognosis (predictive factors), therapeutic effects of cancer on nutritional status, nutritional indicators (biological, anthropometric) and undernutrition in the elderly (specific needs of this population). The potential for nutritional intervention in geriatric oncology with regard to CGA is explored.