AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025390414
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ORIGINAL RESEARCH ARTICLE

Nutritional assessment in daily practice among oncology outpatients: A clinic experience

Meryem Saban Güler1* ,  Saniye Bilici1 ,  Hakan Bulak2
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1 Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
2 General Surgery Clinic, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
EJMO, 025390414 https://doi.org/10.36922/EJMO025390414
Received: 24 September 2025 | Revised: 21 October 2025 | Accepted: 3 November 2025 | Published online: 8 December 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Malnutrition is a common yet frequently underdiagnosed complication in cancer patients and is strongly associated with poor prognosis. Early identification through accurate screening and comprehensive nutritional assessment is essential for improving nutritional status and quality of life.

Objective: The objective of this study was to evaluate the nutritional status of adult cancer patients using the Patient-Generated Subjective Global Assessment (PG-SGA) in combination with anthropometric, biochemical, and dietary parameters.

Methods: This cross-sectional study assessed the nutritional status of 279 adult cancer outpatients using the PG-SGA, supplemented by medical and dietary histories, physical examinations, anthropometric measurements, and laboratory parameters.

Results: According to PG-SGA scores, 31.3% of men and 12.6% of women were classified as severely malnourished. Anthropometric values showed a significant decline across PG-SGA categories, from well-nourished (PG-SGA-A) to severely malnourished (PG-SGA-C) patients (p<0.05). Serum albumin, total protein, hemoglobin, and total cholesterol levels were significantly higher in PG-SGA-A patients, whereas C-reactive protein was elevated in PG-SGA-C patients (p<0.05). Analysis of nutrient intake revealed higher consumption of fiber, fat, saturated fat, and cholesterol among PG-SGA-A patients compared with PG-SGA-C patients (p<0.05). Body weight, body mass index, mid-upper arm circumference, triceps skinfold thickness, mid-upper arm muscle area, mid-upper arm muscle circumference, and lean body mass were all negatively correlated with malnutrition severity (p<0.05).

Conclusion: These findings confirm the high prevalence of malnutrition in oncology outpatients and underscore the importance of integrating both subjective and objective tools for early detection and timely management of malnutrition in cancer care.

Keywords
Cancer
Malnutrition
Patient-Generated Subjective Global Assessment
Nutrition assessment
Nutritional status
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Arends J. Malnutrition in cancer patients: Causes, consequences and treatment options. Eur J Surg Oncol. 2024;50(5):107074. doi: 10.1016/j.ejso.2023.107074

 

  1. Bossi P, Delrio P, Mascheroni A, Zanetti M. The spectrum of malnutrition/cachexia/sarcopenia in oncology according to different cancer types and settings: A narrative review. Nutrients. 2021;13(6):1980. doi: 10.3390/nu13061980

 

  1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi: 10.3322/caac.21834

 

  1. Hosseini SM, Salari N, Darvishi N, et al. Prevalence of severe malnutrition in cancer patients: A systematic review and meta-analysis. J Health Popul Nutr. 2025;44(1):252. doi: 10.1186/s41043-025-01006-x

 

  1. Li W, Yang Y, Li Z, Chen W. Effect of malnutrition and nutritional support to reduce infections in elderly hospitalized patients with cancer: A multicenter survey in China. Nutrition. 2023;106:111894. doi: 10.1016/j.nut.2022.111894

 

  1. Serón-Arbeloa C, Labarta-Monzón L, Puzo-Foncillas J, et al. Malnutrition screening and assessment. Nutrients. 2022;14(12):2392. doi: 10.3390/nu14122392

 

  1. Thompson KL, Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology evidence-based nutrition practice guideline for adults. J Acad Nutr Diet. 2017;117(2):297-310.e47. doi: 10.1016/j.jand.2016.05.010

 

  1. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. doi: 10.1016/j.clnu.2016.07.015

 

  1. Mueller C, Compher C, Ellen DM, American Society for Parenteral and Enteral Nutrition Board of Directors. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. J Parenter Enteral Nutr. 2011;35(1):16-24. doi: 10.1177/0148607110389335

 

  1. Reber E, Schönenberger KA, Vasiloglou MF, Stanga Z. Nutritional risk screening in cancer patients: The first step toward better clinical outcome. Front Nutr. 2021;8:603936. doi: 10.3389/fnut.2021.603936

 

  1. Gil-Andrés D, Cabañas-Alite L. A narrative review comparing nutritional screening tools in outpatient management of cancer patients. Nutrients. 2024;16(5):752. doi: 10.3390/nu16050752

 

  1. Bauer J, Capra S, Ferguson M. Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002;56(8):779-785. doi: 10.1038/sj.ejcn.1601412

 

  1. Pekcan G. Beslenme durumunun saptanması. In: Baysal A, Aksoy M, Besler T, et al., editors. Diyet El Kitabı. 7th ed. Ankara, Turkey: Hatipoğlu Yayınevi; 2013. p. 67-142.

 

  1. World Health Organization. BMI Classification. Geneva, Switzerland: World Health Organization; 2019. Available from: https://apps.who.int/bmi/index. jsp?introPage=intro_3.html [Last accessed on 2025 Apr 23].

 

  1. Marshall KM, Loeliger J, Nolte L, Kelaart A, Kiss NK. Prevalence of malnutrition and impact on clinical outcomes in cancer services: A comparison of two time points. Clin Nutr. 2019;38(2):644-651. doi: 10.1016/j.clnu.2018.04.007

 

  1. Pekcan G. Beslenme Durumunun Saptanması. Ankara, Turkey: T.C. Sağlık Bakanlığı; 2008. Available from: https:// sbu.saglik.gov.tr/Ekutuphane/kitaplar/A%2014.pdf [Last accessed on 2025 Apr 23].

 

  1. Merdol TK. Standart Yemek Tarifleri. 6th ed. Ankara, Turkey: Hatipoğlu Yayınevi; 2016. p. 7-188.

 

  1. Baysal A. Türk Mutfağından Örnekler. 3rd ed. Ankara, Turkey: Hatipoğlu Yayınları; 2003. p. 1-352.

 

  1. Rakıcıoğlu N, Acar Tek N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu: Ölçü ve Miktarlar. Ankara, Turkey: Ata Ofset Matbaacılık; 2009. p. 1-87.

 

  1. Trumbo P, Schlicker S, Yates AA, Poos M, Food and Nutrition Board of the Institute of Medicine, The National Academies. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc. 2002;102(11):1621-1630. doi: 10.1016/s0002-8223(02)90346-9

 

  1. Rodrigues CS, Chaves GV. Patient-Generated Subjective Global Assessment in relation to site, stage of the illness, reason for hospital admission, and mortality in patients with gynecological tumors. Support Care Cancer. 2015;23(3):871-879. doi: 10.1007/s00520-014-2409-7

 

  1. Huang TH, Chi CC, Liu CH, Chang CC, Kuo LM, Hsieh CC. Nutritional status assessed by scored patient-generated subjective global assessment associated with length of hospital stay in adult patients receiving an appendectomy. Biomed J. 2014;37(2):71-77. doi: 10.4103/2319-4170.113183

 

  1. Muhandiramge J, Orchard SG, Warner ET, van Londen GJ, Zalcberg JR. Functional decline in the cancer patient: A review. Cancers (Basel). 2022;14(6):1368. doi: 10.3390/cancers14061368

 

  1. Kose E, Wakabayashi H, Yasuno N. Polypharmacy and malnutrition management of elderly perioperative patients with cancer: A systematic review. Nutrients. 2021;13(6):1961. doi: 10.3390/nu13061961

 

  1. Tomasiewicz A, Polański J, Tański W. Advancing the understanding of malnutrition in the elderly population: Current insights and future directions. Nutrients. 2024;16(15):2502. doi: 10.3390/nu16152502

 

  1. Norman K, Haß U, Pirlich M. Malnutrition in older adults-recent advances and remaining challenges. Nutrients. 2021;13(8):2764. doi: 10.3390/nu13082764

 

  1. Puklin LS, Li F, Cartmel B, et al. Post-diagnosis weight trajectories and mortality among women with breast cancer. NPJ Breast Cancer. 2023;9(1):98. doi: 10.1038/s41523-023-00603-5

 

  1. Mabena N, Rugbeer N, Lehmann S, et al. Association between recorded physical activity and cancer progression or mortality in individuals diagnosed with cancer in South Africa. Br J Sports Med. 2025;59(10):715-721. doi: 10.1136/bjsports-2024-108813

 

  1. Kruk J, Aboul-Enein BH, Gołębiewska ME, et al. Physical activity and cancer incidence and mortality: Current evidence and biological mechanisms. Cancers (Basel). 2025;17(9):1410. doi: 10.3390/cancers17091410

 

  1. Lim HS, Shin EJ, Yeom JW, Park YH, Kim SK. Association between nutrient intake and metabolic syndrome in patients with colorectal cancer. Clin Nutr Res. 2017;6(1):38-46. doi: 10.7762/cnr.2017.6.1.38

 

  1. Chang YY, Hsiao HC, Wang TW. Assessing the impact of exercise on quality of life in advanced-stage cancer patients: A systematic review and network meta-analysis of randomized controlled trials. Cancers (Basel). 2025;17(14):2329. doi: 10.3390/cancers17142329

 

  1. Khorasanchi A, Nemani S, Pandey S, Del Fabbro E. Managing nutrition impact symptoms in cancer cachexia: A case series and mini review. Front Nutr. 2022;9:831934. doi: 10.3389/fnut.2022.831934

 

  1. Wallmander C, Bosaeus I, Silander E, et al. Malnutrition in patients with advanced head and neck cancer: Exploring the Global Leadership Initiative on Malnutrition (GLIM) criteria, energy balance and health-related quality of life. Clin Nutr ESPEN. 2025;66:332-342. doi: 10.1016/j.clnesp.2025.01.049

 

  1. Obaid R, Alkazemi D. Malnutrition and nutrition impact symptoms in Kuwaiti colorectal cancer patients: Validation of PG-SGA short form. Nutrients. 2025;17(17):2770. doi: 10.3390/nu17172770

 

  1. Chiu CH, Yu MR, Huang SC, et al. The impact of chemoradiotherapy on nutritional status and quality of life in esophageal cancer patients during the COVID-19 pandemic: A retrospective study in Taiwan. J Chest Surg. 2025;58:255-263. doi: 10.5090/jcs.25.048

 

  1. Zekri J, Morganti J, Rizvi A, Sadiq BB, Kerr I, Aslam M. Novel simple and practical nutritional screening tool for cancer inpatients: A pilot study. Support Care Cancer. 2014;22(5):1401-1408. doi: 10.1007/s00520-013-2100-4

 

  1. Jamhuri N, Zaidah MYSF, Zaharah AJ, et al. Prevalence of malnutrition among hospitalised adult cancer patients at the National Cancer Institute, Putrajaya, Malaysia. Malays J Nutr. 2017;23(2):161-174.

 

  1. Muscaritoli M, Lucia S, Farcomeni A, et al. Prevalence of malnutrition in patients at first medical oncology visit: The PreMiO study. Oncotarget. 2017;8(45):79884-79896. doi: 10.18632/oncotarget.20168

 

  1. Vidhya K, Gupta S, Lekshmi R, et al. Assessment of nutritional status and correlation of factors with body mass index of cancer patients: A cross-sectional study. Cureus. 2024;16(2):e54146. doi: 10.7759/cureus.54146

 

  1. Alkan ŞB, Artaç M, Rakıcıoğlu N. The relationship between nutritional status and handgrip strength in adult cancer patients: A cross-sectional study. Support Care Cancer. 2018;26(7):2441-2451. doi: 10.1007/s00520-018-4082-8

 

  1. Kang MK, Lee HJ. Impact of malnutrition and nutritional support after gastrectomy in patients with gastric cancer. Ann Gastroenterol Surg. 2024;8(4):534-552. doi: 10.1002/ags3.12788

 

  1. Hamilton KK, Grant BL. Medical nutrition therapy for cancer prevention, treatment, and survivorship. In: Mahan LK, Raymond JL, editors. Krause’s Food and the Nutrition Care Process. 14th ed. St Louis, MO: Elsevier Health Sciences; 2017. p. 729-756.

 

  1. Liposits G, Orrevall Y, Kaasa S, Österlund P, Cederholm T. Nutrition in cancer care: A brief, practical guide with a focus on clinical practice. JCO Oncol Pract. 2021;17(7):e992-e998. doi: 10.1200/OP.21.00169

 

  1. Liu Y, Li F, Hu J, Cui J. The application of immunonutrition in patients with cancer: Current status and future perspectives. Holist Integr Oncol. 2024;3(1):45. doi: 10.1007/s44178-024-00045-3
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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