PD665 - HIDDEN MUSCLE DEPLETION DESPITE NUTRITIONAL SCREENING IN HOSPITALIZED CANCER PATIENTS

PD665

HIDDEN MUSCLE DEPLETION DESPITE NUTRITIONAL SCREENING IN HOSPITALIZED CANCER PATIENTS

M. D. S. Lima¹, T. M. Miola^1,*, A. G. V. Bitencourt²

¹Nutrition, ²Radiology, ACCamargo Cancer Center, São Paulo, Brazil

Rationale: Nutritional screening tools are routinely used to identify hospitalized cancer patients at nutritional risk, but their ability to detect muscle depletion remains uncertain. Failure to recognize these changes may delay targeted supportive treatment.

Methods: This retrospective cross-sectional study included 272 adult cancer patients hospitalized between 2022 and 2023 who underwent abdominal CT and nutritional screening. Skeletal muscle index (SMI) and skeletal muscle density (SMD) were measured at L3 using CoreSlicer®. Low muscle mass was defined as SMI <55 cm²/m² for men and <39 cm²/m² for women. Nutritional risk was assessed by NRS-2002 and the Cancer Nutritional Screening (CNS). 

Results: Low SMI was present in 51.1% and low SMD in 52.2% of patients. NRS-2002 classified 55.1% as not at risk, while CNS classified 73.2% as at risk. NRS-2002 was associated with low SMI (p=0.009), with sensitivity 52% and specificity 63%. CNS showed higher sensitivity (76%) but low specificity (30%). Both tools were associated with low SMD (p<0.05). Patients identified as at risk by NRS-2002 or CNS had significantly longer hospital stays (p<0.001).

Conclusion: Widely used nutritional screening tools fail to identify a substantial proportion of hospitalized cancer patients with CT-defined muscle depletion and poor muscle quality. When routine CT imaging is available, opportunistic body composition analysis may complement screening and improve identification of patients requiring targeted nutritional and supportive care.

References: Arends J et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017; Muscaritoli M et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021; Prado CM et al. Sarcopenia and cachexia in the era of obesity. Proc Nutr Soc. 2016; Ní Bhuachalla ÉB et al. CT diagnosed cachexia and sarcopenia: is nutritional screening capturing hidden malnutrition? J Cachexia Sarcopenia Muscle. 2018

Disclosure of Interest: None declared