Nutritional status at diagnosis among children with cancer referred to a nutritional service in Brazil

Abstract

Introduction: Children and adolescents with cancer are particularly vulnerable to malnutrition and require special attention on nutritional assessment. An adequate nutritional status during treatment is essential in reducing morbidity and mortality, being a modifiable risk factor for clinical outcomes. This study aims to determine the nutritional status of pediatric patients with cancer assessed by the nutrition team at diagnosis and evaluate its association with the overall survival. Method: This is a retrospective cross-sectional study of patients at the time of cancer diagnosis who had nutritional assessments when hospitalized or referred to the nutrition outpatient clinic. Nutritional status was classified by the mid-upper arm circumference (MUAC) and body mass index for age z-score (zBMI/A). The Cox regression analysis was used to determine the association between the nutritional status and overall survival, adjusting for gender, tumor group and age. Results: The study included 366 patients. The prevalence of undernutrition varied from 8 to 23% and overweight, from 5 to 20%. The MUAC identified more children as undernourished than the zBMI/A in patients with solid and hematological tumors. There was no significant difference in the overall survival by malnutrition classified by the zBMI/A (p = 0.1507) or MUAC (p = 0.8135). When adjusted for gender, tumor group and age, the nutritional status classification by the zBMI/A (hazard ratio [HR], 1.27; 95% confidence interval [CI], 0.88–1.83; p = 0.209) and MUAC (HR, 0.94; 95% CI, 0.61–1.44; p = 0.773) did not impact overall survival. Conclusion: The nutritional status at diagnosis did not significantly impact the overall survival, which suggests there may have been a protective effect by successful nutritional intervention during the subsequent care.

Keywords

• Nutritional status
• Child
• Adolescent
• Neoplasms/metabolism
• Brazil