Differential associations of GLIM-defined malnutrition components with survival in colorectal cancer: a prospective...

Malnutrition is common among patients with colorectal cancer (CRC) and is associated with poorer treatment response and survival. However, no consensus exists on which combination of the Global Leadership Initiative on Malnutrition (GLIM) criteria best predicts survival in this population. This study aimed to to investigate the differential associations between the individual components of GLIM-defined malnutrition and overall survival in patients with colorectal cancer who received anticancer treatment during the follow-up period.

This longitudinal, prospective, observational study was conducted at a tertiary oncology hospital, including newly diagnosed CRC patients. Malnutrition was diagnosed according to GLIM, combining phenotypic criteria (weight loss, low BMI, and reduced muscle mass, assessed by computed tomography or bioelectrical impedance analysis) and etiologic criteria (reduced food intake, evaluated by the Patient-Generated Subjective Global Assessment [PG-SGA], and inflammation, assessed by tumor stage or neutrophil-to-lymphocyte ratio). Two-year overall survival was analyzed using Kaplan-Meier and Cox proportional hazards models.

Eighty-one patients were included (median age 62 years; IQR 55-71); 75% had advanced disease (stage III-IV). Malnutrition prevalence ranged from 6% to 57%, depending on the GLIM combination applied. In multivariate analysis, advanced disease stage (HR 4.90; 95% CI 1.72-13.94; P = 0.003) and the combination of low muscle mass and reduced food intake (HR 3.44; 95% CI 1.15-10.28; P = 0.027) were independent predictors of poorer overall survival.

In the studied population, the combination of low muscle mass and reduced food intake emerged as an independent predictor of two-year survival.