Current status of the association between malnutrition defined by the GLIM criteria and postoperative outcomes in gastrointestinal surgery for cancer: a narrative review

• Published in: Journal of cancer research and clinical oncology Vol. 149; no. 4; pp. 1635 - 1643
• Main Authors: Matsui, Ryota, Rifu, Kazuma, Watanabe, Jun, Inaki, Noriyuki, Fukunaga, Tetsu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2023; Springer Nature B.V
• Subjects: Body mass index; Body weight loss; Cancer; Cancer Research; Complications; Digestive System Surgical Procedures - adverse effects; Hematology; Humans; Internal Medicine; Malnutrition; Malnutrition - diagnosis; Malnutrition - etiology; Medicine; Medicine & Public Health; Neoplasms; Nutrition Assessment; Nutritional Status; Oncology; Population studies; Postoperative; Postoperative Complications; Postoperative period; Review; Risk factors; Sarcopenia; Sarcopenia - diagnosis; Undernutrition; Prognosis; Gastrointestinal surgery; Malnutrition; Nutritional screening; Postoperative complications; GLIM criteria
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-022-04175-y

In 2018, the Global Leadership Initiative on Malnutrition consortium published global consensus diagnostic criteria for malnutrition and highlighted the association between malnutrition and poor postoperative outcomes in patients with gastrointestinal cancer. The aforementioned criteria consist of phenotypic and etiologic criteria to diagnose malnutrition in individuals who undergo conventional screening to determine the at-risk population. Recent studies have reported the usefulness of prediction of postoperative outcomes using body mass index, weight loss, and reduced muscle mass as phenotypic criteria. Reduced muscle mass is an essential diagnostic criterion for sarcopenia, which is associated with poor outcomes in patients with cancer. The Global Leadership Initiative on Malnutrition criteria define reduced muscle mass as undernutrition. Malnutrition diagnosed based on the Global Leadership Initiative on Malnutrition criteria is an important risk factor for postoperative complications and also an independent poor prognostic factor for long-term outcomes; greater severity of malnutrition is associated with poorer outcomes. The current Global Leadership Initiative on Malnutrition criteria for malnutrition accurately predict outcomes, including postoperative complications and long-term prognosis; however, a revision may be warranted to ensure consistency with the diagnostic criteria for sarcopenia. Patients diagnosed with malnutrition based on the Global Leadership Initiative on Malnutrition criteria should be targeted for nutritional intervention. Further accumulation of evidence is necessary to conclusively establish the role of nutritional interventions in patients with malnutrition to improve postoperative complications and long-term outcomes.