5 Nutritional Screening Tools Best at Predicting Prognosis in Pancreatic Cancer

A systematic review and meta-analysis found the Controlling Nutritional Status Score (CONUT) to be the best nutritional assessment tool for predicting mortality among patients with pancreatic cancer (PC). These findings were published in Nutrition Journal.

Malnutrition is common in patients with pancreatic cancer and nutritional status has been associated with patient outcomes.

To determine which nutritional evaluation tools have the best prognostic value in pancreatic cancer, investigators from the Nanjing Medical University in China searched publication databases through December 2023 for relevant studies.

Twenty-seven studies, comprising 6060 patients with pancreatic cancer, were included in this review. The studies were conducted in Asia, the United States, and Europe.

A total of 9 malnutrition risk screening tools were evaluated across the studies: CONUT, the Glasgow Prognostic Score (GPS), the modified GPS (mGPS), the Malnutrition Universal Screening Tool (MUST), the Nutrition Risk Screening (NRS2002), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), the Prognostic Nutritional Index (PNI), and the Short Form Mini Nutritional Assessment (MNA-SF). 

Three malnutrition assessment tools also were evaluated: the Short Form Mini Nutritional Assessment (MNA-SF), the Generated Subjective Global Assessment (SGA), and the Patient-Generated SGA (PG-SGA).

Risk of all-cause mortality was associated with poor nutritional status as determined by the CONUT (hazard ratio [HR], 1.978; P =.001), the GNRI (HR, 1.595; P =.036), the GPS (HR, 1.464; P <.001), the NRS2002 (HR, 1.248; P <.001), and the PNI (HR, 1.504; P <.001) instruments.

Subgroup analyses identified inconsistent results for the CONUT tool in studies conducted in China and for the GPS tool when a cut-off score of 2 was used, in which no significant association with mortality was observed in these subgroups.

A major limitation of this study was the large heterogeneity observed among the studies.

“We found that poor nutritional status evaluated through GNRI, PNI, CONUT, NRS2002, and GPS significantly predicted mortality from all causes in [patients with pancreatic cancer]. A nutritional screening tool with the highest predictive value was CONUT,” concluded the study authors.