Prevalence and Prognostic Role of Nutrition Impact Symptoms in Patients With Gastrointestinal Cancer: A Multicenter Cohort Study

Background/Aim: Patients with gastrointestinal cancer (GIC) often experience prevalent and severe malnutrition. Nutrition impact symptoms (NIS) can cause malnutrition but have not been fully addressed in GIC. This study comprehensively evaluated the prevalence and prognostic value of NIS in GIC. Patients and Methods: Baseline and laboratory characteristics of 6,732 patients with GIC were obtained from the INSCOC study. NIS includes inappetence, dysphagia, pain, nausea, early satiety, astriction, vomiting, xerostomia, diarrhea, dysgeusia, dysosmia, and mouth ulcer. The association between NIS and overall survival (OS) was determined using Cox regression analysis. NIS that showed independent prognostic values were included in subsequent analyses and defined as GIC-prognosis-related NIS (GICPNIS). GICPNIS score and weighted GICPNIS score were formulated based on the number and weight of GICPNIS, respectively. Results: Of 6,732 patients, 2,877 patients had NIS. Multivariate analysis showed that inappetence [hazard ratio (HR)=1.20, 95% confidence interval (CI)=1.09-1.32], nausea (HR=1.31, 95%CI=1.16-1.47), vomiting (HR=1.40, 95%CI=1.22-1.60), dysphagia (HR=1.47, 95%CI=1.31-1.64), early satiety (HR=1.35, 95%CI=1.18-1.54), and pain (HR=1.53, 95%CI=1.29-1.81) were independent prognostic factors of patients with GIC (all p<0.001). Weighted GICPNIS score could better discriminate OS than GICPNIS score. Conclusion: Among patients with GIC, 42.7% experienced various NIS. Inappetence, nausea, vomiting, dysphagia, early satiety, and pain were independent prognostic factors of patients with GIC. Weighted GICPNIS score could better discriminate OS than GICPNIS score.