# Investigating the nutritional status characteristics of terminal cancer patients by the type of cancer

## TL;DR

This study examines how the type of cancer affects the nutritional status and prognosis of terminal cancer patients, finding that gastrointestinal cancer patients have worse nutrition and outcomes.

## Contribution

The study provides new insights into the relationship between cancer type and nutritional status in terminal patients, emphasizing the need for tailored nutritional management.

## Key findings

- Gastrointestinal cancer patients had significantly lower serum albumin and transthyretin levels compared to non-gastrointestinal cancer patients.
- Gastrointestinal tract cancer patients had lower albumin levels than hepato-biliary-pancreas cancer patients.
- Poor nutritional status in terminal cancer patients is associated with worse prognosis, especially in gastrointestinal cancer cases.

## Abstract

Patients with terminal cancer experience malnutrition due to cachexia and other problems associated with the disease’s progression. Particularly, patients with gastrointestinal cancers often experience malnutrition because of gastrointestinal symptoms; however, there are few reports evaluating nutritional status based on cancer type up to the prediction of prognosis. In the present study, we examined nutritional evaluation and prognosis based on cancer type.

In 2019, 234 patients were admitted to Fujita Health University Nanakuri Memorial Hospital and subsequently died before being discharged. Of these patients, 210 were included in the study. Twenty-four patients who were determined to have refractory cachexia on admission were excluded. The 210 patients were divided into two groups, 94 and 116 patients with gastrointestinal cancers and non-gastrointestinal cancers, respectively. Subsequently, data, such as age, sex, presence or absence of metastasis, whether the cancer was initial or recurrent, serum albumin (Alb) and transthyretin (TTR) levels on admission, and survival time were examined. Moreover, for further analysis, the 94 patients with gastrointestinal cancers were classified into 51 and 43 with hepato-biliary-pancreas cancer and gastrointestinal tract cancers, respectively.

Alb and TTR values were significantly lower in patients with gastrointestinal cancer than in patients with non-gastrointestinal cancer (p=0.015 and 0.002, respectively), and Alb values were significantly lower in patients with gastrointestinal tract cancer than in patients with hepato-biliary-pancreas cancer (p=0.049).

Patients with terminal cancer having poor nutritional status exhibit poor prognosis. Particularly, among patients with gastrointestinal tract cancer have exceptionally poor nutritional status. Therefore, providing nutritional management that combines intravenous nutrition with appropriate adjustments to each patient’s gastrointestinal and absorptive condition is important.