Malnutrition and Sarcopenia Screening in Chemotherapy Patients

Background: Malnutrition and sarcopenia are prevalent and clinically significant conditions in cancer patients receiving chemotherapy. Accurate nutritional screening and early diagnosis of sarcopenia are critical for improving treatment outcomes and quality of life. Several screening tools are used for nutritional risk assessment in oncology, including PG-SGA, MUST, Nutriscore, and the recently proposed GLIM criteria.

Objective: This cross-sectional study aims to evaluate the risk of malnutrition and sarcopenia in solid tumor outpatients receiving chemotherapy. It compares the effectiveness and correlation of PG-SGA, MUST, Nutriscore, and GLIM criteria, and investigates their association with sarcopenia, measured via handgrip strength and CT-based skeletal muscle index at the L3 level.

Methods: Approximately 150 adult cancer patients receiving active outpatient chemotherapy will be assessed. Nutritional status will be evaluated using PG-SGA, MUST, Nutriscore, and GLIM. Sarcopenia will be determined via handgrip strength testing and analysis of CT images. Charlson Comorbidity Index will be used to assess comorbidity burden.

Inclusion criteria

• Age ≥ 18 years
• Diagnosed with a solid tumor (e.g., breast, lung, GI, gynecologic cancers)
• Receiving active outpatient chemotherapy
• Recent abdominal CT scan within the last 3 months or planned
• Provided written informed consent
• Physically and mentally able to complete study procedures

Exclusion criteria

• Declined or unable to give informed consent
• Cognitive impairment or mental status preventing participation
• Neuromuscular diseases affecting muscle mass (e.g., myopathy, MND, severe neuropathy)
• Inadequate CT image quality for L3 analysis
• Acute infection or illness within the past month
• Upper limb deformity or severe pain preventing handgrip testing
• Incomplete assessments or withdrawal of consent during the study