Aim
To assess longitudinal changes in nutrition impact symptoms (NIS) and determine the association with malnutrition, loss of weight (LOW), and muscle loss within 12 months of oesophagogastric (OG) cancer surgery.
Methods
This prospective observational study included patients who had OG cancer surgery. Data were collected preoperatively and at multiple time points up to 12-months postoperatively. Validated oncology quality-of-life questionnaires measured NIS. Muscle loss was determined using computed tomography to quantify percentage change in skeletal muscle index (SMI cm2/m2) from diagnosis. Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition definition. Spearman correlations assessed relationships between NIS, weight and muscle loss. T-tests (Wilcoxon) compared NIS between malnourished and well-nourished groups.
Results
Fifty patients (62% male, mean age 64 ± 10.3 years) were included preoperatively, with 32 patients at 12 months. Preoperatively, pain (r = 0.376, p = 0.016), appetite loss (r = 0.478, p = 0.002), dysphagia (r = 0.554, p <0.001), eating restriction (r = 0.460, p = 0.002), odynophagia (r = 0.360, p = 0.021) and taste changes (r = 0.405, p = 0.009) showed moderate to strong positive correlations with percentage LOW. At 12-months, dysphagia (r = -0.381, p = 0.034), eating restriction (r = -0.411, p = 0.022), and odynophagia (r = -0.417, p = 0.020) showed a moderate negative correlation with percentage SMI change, and no correlations were found between NIS and LOW. Malnourished patients had worse dysphagia (18.4 vs 4.6, p = 0.034) and eating restriction scores (32.9 vs 15.6, p = 0.043) compared to well-nourished patients preoperatively. There were no differences in NIS between groups at 12 months.
Conclusions
Nutrition impact symptoms were associated with weight loss and malnutrition preoperatively and with muscle loss following OG cancer surgery. NIS may be important nutrition risk indicators, supporting ongoing symptom surveillance and nutrition intervention.