ASSOCIATION BETWEEN CANCER TYPE AND GLIM-DEFINED MALNUTRITION IN PATIENTS UNDERGOING CHEMOTHERAPY: A CROSS-SECTIONAL STUDY
HUBUNGAN ANTARA JENIS KANKER DENGAN DERAJAT MALNUTRISI BERDASARKAN KRITERIA GLIM PADA PASIEN KEMOTERAPI: STUDI POTONG LINTANG
Abstract
Malnutrition is a common complication in patients with cancer and is associated with poorer clinical outcomes.1 The Global Leadership Initiative on Malnutrition (GLIM) criteria provide an international consensus for diagnosing malnutrition.2 However, evidence regarding variations in malnutrition severity across different cancer types remains limited. Objective: This study aimed to evaluate the association between cancer type and malnutrition severity defined by the GLIM criteria among patients with cancer undergoing chemotherapy. Methods: This descriptive cross-sectional study was conducted among adult cancer patients receiving chemotherapy at Prof. dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia, between October 2025 and January 2026. Nutritional status was assessed using the GLIM criteria. The association between cancer type and malnutrition severity was analyzed using the chi-square test. Results: A total of 107 patients were included. Lung cancer was the most common malignancy (42.1%), followed by breast (38.3%), ovarian (15.9%), and prostate cancer (3.7%). Overall, 46.7% of patients were malnourished, including 22.4% with moderate and 24.3% with severe malnutrition. The highest prevalence of malnutrition was observed in lung cancer patients (73.3%). A significant association was found between cancer type and malnutrition severity (p<0.001). Conclusion: Malnutrition is common among patients with cancer undergoing chemotherapy, and its severity varies according to cancer types.
References
Gascón-Ruiz M, Casas-Deza D, Marti-Pi M, et al. Diagnosis of Malnutrition According to GLIM Criteria Predicts Complications and 6-Month Survival in Cancer Outpatients. Biomedicines. 2022;10(9):2201.
Cederholm T, Jensen GL, Correia MITD, et al. The GLIM consensus approach to diagnosis of malnutrition: A 5-year update. Clinical Nutrition. 2025;49:11-20.
Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263.
Caccialanza R, Cotogni P, Cereda E, et al. Nutritional Support in Cancer patients: update of the Italian Intersociety Working Group practical recommendations. J Cancer. 2022;13(9):2705.
Beirer A. Malnutrition and cancer, diagnosis and treatment. memo - Magazine of European Medical Oncology 2021 14:2. 2021;14(2):168-173.
Arends J. Malnutrition in cancer patients: Causes, consequences and treatment options. European Journal of Surgical Oncology. 2024;50(5):107074.
Muscaritoli M, Arends J, Bachmann P, et al. ESPEN Guideline ESPEN practical guideline: Clinical Nutrition in cancer. Published online 2021.
Kashif H, Raza Q, Nawaz S, et al. The Impact of Chemotherapy on the Nutritional Status of Breast Cancer Patients. Cureus. 2024;16(12):e76549.
Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018;4.
Liu C, Lu Z, Li Z, Xu J, Cui H, Zhu M. Influence of Malnutrition According to the GLIM Criteria on the Clinical Outcomes of Hospitalized Patients With Cancer. Front Nutr. 2021;8:774636.
Huo Z, Chong F, Yin L, et al. Comparison of the performance of the GLIM criteria, PG-SGA and mPG-SGA in diagnosing malnutrition and predicting survival among lung cancer patients: A multicenter study. Clinical Nutrition. 2023;42(6):1048-1058.
Beirer A. Malnutrition and cancer, diagnosis and treatment. Memo - Magazine of European Medical Oncology. 2021;14(2):168-173.
Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018;4.
Morita-Tanaka S, Yamada T, Takayama K. The landscape of cancer cachexia in advanced non-small cell lung cancer: a narrative review. Transl Lung Cancer Res. 2023;12(1):168-180.
Sankar K, Kazemian E, Lorona N, et al. Circulating Inflammatory and Mitochondrial Biomarkers Associated with Cachexia in Advanced Non-Small Cell Lung Cancer. Cancers 2026, Vol 18, Page 655. 2026;18(4):655.
Silva RJG, Grippa WR, Neto LCBS, et al. Factors Associated with the Nutritional Status of Women with Non-Metastatic Breast Cancer in a Brazilian High Complexity Oncology Center. Nutrients 2023, Vol 15, Page 4961. 2023;15(23):4961.
Okuni I, Otsubo Y, Ebihara S. Molecular and Neural Mechanism of Dysphagia Due to Cancer. Int J Mol Sci. 2021;22(13):7033.
Shao Z, Fu L, Lu Y, Zhou H, Zhu Y, Zhu T. Ovarian cancer and malnutrition: a literature review. Transl Cancer Res. 2025;14(5):3239-3254.
Cui F, Zhang Y, Tang X, et al. Weight gain or loss after diagnosis and survival outcomes in prostate cancer: a meta-analysis. BMC Cancer. 2025;25(1).
Cavka L, Pohar Perme M, Rotovnik Kozjek N, Seruga B. Prognostic Impact of Nutritional Status on Overall Survival and Health-Related Quality of Life in Men with Advanced Prostate Cancer. Nutrients. 2023;15(4):1044.
Wang YF, An ZY, Lin DH, Jin WL. Targeting cancer cachexia: Molecular mechanisms and clinical study. MedComm (Beijing). 2022;3(4):e164.
Mariean CR, Tiucă OM, Mariean A, Cotoi OS. Cancer Cachexia: New Insights and Future Directions. Cancers (Basel). 2023;15(23):5590.
Setiawan T, Sari IN, Wijaya YT, et al. Cancer cachexia: molecular mechanisms and treatment strategies. Journal of Hematology & Oncology 2023 16:1. 2023;16(1):1-26.
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