Xiaotao Zhang1, Tenglong Tang2, Linda Pang3, Shreela V Sharma4, Ruosha Li5, Alan G Nyitray6, Beatrice J Edwards7. 1. Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, United States of America; General Internal Medicine, University of Texas, MD Anderson Cancer Center, United States of America. 2. Department of The Gastroenterology, Hepatology and Nutrition, Cancer Center, University of Texas, MD, Anderson, United States of America. 3. General Internal Medicine, University of Texas, MD Anderson Cancer Center, United States of America. 4. Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas, Health Science Center at Houston, United States of America. 5. Department of Biostatistics and Data Science, University of Texas, Health Science Center at Houston, United States of America. 6. Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin Cancer Center, United States of America. 7. Central Texas Veterans Healthcare System, United States of America. Electronic address: Beatrice.Edwards@va.gov.
Abstract
BACKGROUND: Some studies have shown that malnutrition is associated with increased risk of mortality in older adults with cancer. However, evidence of its effect is limited and inconsistent. To assess the effect of malnutrition on overall survival in older adults with cancer, we performed a meta-analysis of available studies. METHODS: We systematically searched MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO for observational studies that examined the association between malnutrition and risk of mortality in older adults with cancer (≥65 years). Malnutrition is defined according to assessment and screening tools in different studies. Older adults with malnutrition were compared with those with normal nutrition for overall survival. A random-effect model was fitted to estimate the summary relative risk (RR) and 95% confidence interval (CI). Between-studies heterogeneity was measured with the I2 statistic. RESULTS: Ten studies met the inclusion criteria, and a total of 4692 older adults with cancer were included in the meta-analysis. Heterogeneity existed among the different studies (I2 = 73.7%, p < 0.01). Malnutrition was significantly positively associated with increased risk of all-cause mortality (RR: 1.73; 95% CI: 1.23-2.41) compared with those with good nutrition status. A sensitivity analysis of 2773 older adults with cancer on the malnutrition assessed by Mini Nutrition Assessment (MNA), found that malnutrition is still associated with higher risk for all-cause mortality (RR = 2.13, 95% CI: 1.34-3.39). CONCLUSION: Our meta-analysis of observational studies found a significant effect of malnutrition on overall survival in older adults with cancer.
BACKGROUND: Some studies have shown that malnutrition is associated with increased risk of mortality in older adults with cancer. However, evidence of its effect is limited and inconsistent. To assess the effect of malnutrition on overall survival in older adults with cancer, we performed a meta-analysis of available studies. METHODS: We systematically searched MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO for observational studies that examined the association between malnutrition and risk of mortality in older adults with cancer (≥65 years). Malnutrition is defined according to assessment and screening tools in different studies. Older adults with malnutrition were compared with those with normal nutrition for overall survival. A random-effect model was fitted to estimate the summary relative risk (RR) and 95% confidence interval (CI). Between-studies heterogeneity was measured with the I2 statistic. RESULTS: Ten studies met the inclusion criteria, and a total of 4692 older adults with cancer were included in the meta-analysis. Heterogeneity existed among the different studies (I2 = 73.7%, p < 0.01). Malnutrition was significantly positively associated with increased risk of all-cause mortality (RR: 1.73; 95% CI: 1.23-2.41) compared with those with good nutrition status. A sensitivity analysis of 2773 older adults with cancer on the malnutrition assessed by Mini Nutrition Assessment (MNA), found that malnutrition is still associated with higher risk for all-cause mortality (RR = 2.13, 95% CI: 1.34-3.39). CONCLUSION: Our meta-analysis of observational studies found a significant effect of malnutrition on overall survival in older adults with cancer.
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