Oncology-Led Early Identification of Nutritional Risk: A Pragmatic, Evidence-Based Protocol (PRONTO)

Scientific paper - Original scientific paper

• Author: Maurizio Muscaritoli
• Author: Gil Bar-Sela
• Author: Nicolo Matteo Luca Battisti
• Author: Borislav Belev
• Author: Jorge Contreras-Martínez
• Author: Enrico Cortesi
• Author: Ione de Brito-Ashurst
• Author: Carla M. Prado
• Author: Paula Ravasco
• Author: Suayib Yalcin
• Author's institution: University of Zagreb; School of Medicine; (Department of Pathophysiology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathophysiology

Abstract (english)

Nutritional issues, including malnutrition, low muscle mass, sarcopenia (i.e., low muscle mass and strength), and cachexia (i.e., weight loss characterized by a continuous decline in skeletal muscle mass, with or without fat loss), are commonly experienced by patients with cancer at all stages of disease. Cancer cachexia may be associated with poor nutritional status and can compromise a patient’s ability to tolerate antineoplastic therapy, increase the likelihood of post-surgical complications, and impact long-term outcomes including survival, quality of life, and function. One of the primary nutritional problems these patients experience is malnutrition, of which muscle depletion represents a clinically relevant feature. There have been recent calls for nutritional screening, assessment, treatment, and monitoring as a consistent component of care for all patients diagnosed with cancer. To achieve this, there is a need for a standardized approach to enable oncologists to identify patients commencing and undergoing antineoplastic therapy who are or who may be at risk of malnutrition and/or muscle depletion. This approach should not replace existing tools used in the dietitian’s role, but rather give the oncologist a simple nutritional protocol for optimization of the patient care pathway where this is needed. Given the considerable time constraints in day-to-day oncology practice, any such approach must be simple and quick to implement so that oncologists can flag individual patients for further evaluation and follow-up with appropriate members of the multidisciplinary care team. To enable the rapid and routine identification of patients with or at risk of malnutrition and/or muscle depletion, an expert panel of nutrition specialists and practicing oncologists developed the PROtocol for NuTritional risk in Oncology (PRONTO). The protocol enables the rapid identification of patients with or at risk of malnutrition and/or muscle depletion and provides guidance on next steps. The protocol is adaptable to multiple settings and countries, which makes implementation feasible by oncologists and may optimize patient outcomes. We advise the use of this protocol in countries/clinical scenarios where a specialized approach to nutrition assessment and care is not available.

• Keywords (english): PRONTO; antineoplastic therapy; cachexia; cancer; malnutrition; mobility; nutrition; protocol; risk identification; sarcopenia; strength
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Cancers
• Numbering: vol. 15, no. 2, 380
• e-ISSN: 2072-6694
• DOI: https://doi.org/10.3390/cancers15020380
• URN:NBN: urn:nbn:hr:105:532728
• Publication: 2023-01-06
• Document URL: https://www.mdpi.com/2072-6694/15/2/380
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-02-15 10:13:08