TY - JOUR
T1 - Malnutrition and overall survival in older adults with cancer
T2 - A systematic review and meta-analysis
AU - Zhang, Xiaotao
AU - Tang, Tenglong
AU - Pang, Linda
AU - Sharma, Shreela V.
AU - Li, Ruosha
AU - Nyitray, Alan G.
AU - Edwards, Beatrice J.
N1 - Funding Information:
This work was funded (in part) by a Research Training Award for Cancer Prevention Post-Graduate Training Program in Integrative Epidemiology from the Cancer Prevention & Research Institute of Texas , grant number RP160097 (PI: M. Spitz).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/11
Y1 - 2019/11
N2 - Background: Some studies have shown that malnutrition is associated with increased risk of mortality in older adults with cancer. However, evidence of its effect is limited and inconsistent. To assess the effect of malnutrition on overall survival in older adults with cancer, we performed a meta-analysis of available studies. Methods: We systematically searched MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO for observational studies that examined the association between malnutrition and risk of mortality in older adults with cancer (≥65 years). Malnutrition is defined according to assessment and screening tools in different studies. Older adults with malnutrition were compared with those with normal nutrition for overall survival. A random-effect model was fitted to estimate the summary relative risk (RR) and 95% confidence interval (CI). Between-studies heterogeneity was measured with the I2 statistic. Results: Ten studies met the inclusion criteria, and a total of 4692 older adults with cancer were included in the meta-analysis. Heterogeneity existed among the different studies (I2 = 73.7%, p < 0.01). Malnutrition was significantly positively associated with increased risk of all-cause mortality (RR: 1.73; 95% CI: 1.23–2.41) compared with those with good nutrition status. A sensitivity analysis of 2773 older adults with cancer on the malnutrition assessed by Mini Nutrition Assessment (MNA), found that malnutrition is still associated with higher risk for all-cause mortality (RR = 2.13, 95% CI: 1.34–3.39). Conclusion: Our meta-analysis of observational studies found a significant effect of malnutrition on overall survival in older adults with cancer.
AB - Background: Some studies have shown that malnutrition is associated with increased risk of mortality in older adults with cancer. However, evidence of its effect is limited and inconsistent. To assess the effect of malnutrition on overall survival in older adults with cancer, we performed a meta-analysis of available studies. Methods: We systematically searched MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO for observational studies that examined the association between malnutrition and risk of mortality in older adults with cancer (≥65 years). Malnutrition is defined according to assessment and screening tools in different studies. Older adults with malnutrition were compared with those with normal nutrition for overall survival. A random-effect model was fitted to estimate the summary relative risk (RR) and 95% confidence interval (CI). Between-studies heterogeneity was measured with the I2 statistic. Results: Ten studies met the inclusion criteria, and a total of 4692 older adults with cancer were included in the meta-analysis. Heterogeneity existed among the different studies (I2 = 73.7%, p < 0.01). Malnutrition was significantly positively associated with increased risk of all-cause mortality (RR: 1.73; 95% CI: 1.23–2.41) compared with those with good nutrition status. A sensitivity analysis of 2773 older adults with cancer on the malnutrition assessed by Mini Nutrition Assessment (MNA), found that malnutrition is still associated with higher risk for all-cause mortality (RR = 2.13, 95% CI: 1.34–3.39). Conclusion: Our meta-analysis of observational studies found a significant effect of malnutrition on overall survival in older adults with cancer.
KW - Malnutrition
KW - Meta-analysis
KW - Older adults with cancer
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U2 - 10.1016/j.jgo.2019.03.002
DO - 10.1016/j.jgo.2019.03.002
M3 - Article
C2 - 30917937
AN - SCOPUS:85063277832
SN - 1879-4068
VL - 10
SP - 874
EP - 883
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 6
ER -