Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review

Abstract Background Patients with cancer have an increased risk of malnutrition which is associated with poor outcome. The Mini Nutritional Assessment (MNA®) is often used in older patients with cancer but its relation to outcome is not known. Methods Four databases were systematically searched for...

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Main Authors: G. Torbahn, T. Strauss, C. C. Sieber, E. Kiesswetter, D. Volkert
Format: Article
Language:English
Published: BMC 2020-06-01
Series:BMC Cancer
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12885-020-07052-4
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author G. Torbahn
T. Strauss
C. C. Sieber
E. Kiesswetter
D. Volkert
author_facet G. Torbahn
T. Strauss
C. C. Sieber
E. Kiesswetter
D. Volkert
author_sort G. Torbahn
collection DOAJ
description Abstract Background Patients with cancer have an increased risk of malnutrition which is associated with poor outcome. The Mini Nutritional Assessment (MNA®) is often used in older patients with cancer but its relation to outcome is not known. Methods Four databases were systematically searched for studies relating MNA-results with any reported outcome. Two reviewers screened titles/abstracts and full-texts, extracted data and rated the risk of bias (RoB) independently. Results We included 56 studies which varied widely in patient and study characteristics. In multivariable analyses, (risk of) malnutrition assessed by MNA significantly predicts a higher chance for mortality/poor overall survival (22/27 studies), shorter progression-free survival/time to progression (3/5 studies), treatment maintenance (5/8 studies) and (health-related) quality of life (2/2 studies), but not treatment toxicity/complications (1/7 studies) or functional status/decline in (1/3 studies). For other outcomes – length of hospital stay (2 studies), falls, fatigue and unplanned (hospital) admissions (1 study each) – no adjusted results were reported. RoB was rated as moderate to high. Conclusions MNA®-result predicts mortality/survival, cancer progression, treatment maintenance and (health-related) quality of life and did not predict adverse treatment outcomes and functional status/ decline in patients with cancer. For other outcomes results are less clear. The moderate to high RoB calls for studies with better control of potential confounders.
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spelling doaj.art-ccf74ba6feaa4b7a8ee2eb00a7e3fa7c2022-12-22T00:51:29ZengBMCBMC Cancer1471-24072020-06-0120111810.1186/s12885-020-07052-4Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic reviewG. Torbahn0T. Strauss1C. C. Sieber2E. Kiesswetter3D. Volkert4Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-NürnbergInstitute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-NürnbergInstitute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-NürnbergInstitute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-NürnbergInstitute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-NürnbergAbstract Background Patients with cancer have an increased risk of malnutrition which is associated with poor outcome. The Mini Nutritional Assessment (MNA®) is often used in older patients with cancer but its relation to outcome is not known. Methods Four databases were systematically searched for studies relating MNA-results with any reported outcome. Two reviewers screened titles/abstracts and full-texts, extracted data and rated the risk of bias (RoB) independently. Results We included 56 studies which varied widely in patient and study characteristics. In multivariable analyses, (risk of) malnutrition assessed by MNA significantly predicts a higher chance for mortality/poor overall survival (22/27 studies), shorter progression-free survival/time to progression (3/5 studies), treatment maintenance (5/8 studies) and (health-related) quality of life (2/2 studies), but not treatment toxicity/complications (1/7 studies) or functional status/decline in (1/3 studies). For other outcomes – length of hospital stay (2 studies), falls, fatigue and unplanned (hospital) admissions (1 study each) – no adjusted results were reported. RoB was rated as moderate to high. Conclusions MNA®-result predicts mortality/survival, cancer progression, treatment maintenance and (health-related) quality of life and did not predict adverse treatment outcomes and functional status/ decline in patients with cancer. For other outcomes results are less clear. The moderate to high RoB calls for studies with better control of potential confounders.http://link.springer.com/article/10.1186/s12885-020-07052-4NeoplasmsNutritional statusMalnutritionNutrition assessmentPrognosisSystematic review
spellingShingle G. Torbahn
T. Strauss
C. C. Sieber
E. Kiesswetter
D. Volkert
Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review
BMC Cancer
Neoplasms
Nutritional status
Malnutrition
Nutrition assessment
Prognosis
Systematic review
title Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review
title_full Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review
title_fullStr Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review
title_full_unstemmed Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review
title_short Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review
title_sort nutritional status according to the mini nutritional assessment mna r as potential prognostic factor for health and treatment outcomes in patients with cancer a systematic review
topic Neoplasms
Nutritional status
Malnutrition
Nutrition assessment
Prognosis
Systematic review
url http://link.springer.com/article/10.1186/s12885-020-07052-4
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