Abstract 4147
Background
Cancer-related weight loss correlates with poor anticancer treatment (Tx) outcomes and reduced quality of life (QoL). A survey at ESMO 2016 suggested that integration of nutritional care in clinical practice is inadequate. Outcomes of a follow-up survey conducted at ESMO 2017 are reported.
Methods
ESMO 2017 delegates visiting the Nutricia booth took part in the survey. The 2017 survey questions were identical to 2016, except 1 new question: “What source helps to determine patient need for nutritional support?”
Results
The 1,894 participants (75% medical oncologists; 64% European) demonstrated consistent overall practice patterns (malnutrition screening and assessment methods, eligibility criteria for nutritional support, goals of nutritional treatment, multimodal management) between 2016–2017. Unfortunately, >40% of HCPs still underestimate the impact of malnutrition on anticancer Tx continuity or toxicity, and QoL or function. Timely and individual tailored dietary advice to minimize/avoid weight loss increased significantly (36% to 49%; P <.001), surpassing medications, but only in Western countries (53%). Further geographic differences were seen. For example, in Africa (n = 183) compared with Europe (n = 1,215), nutritional aspects were more often considered in tumor boards (70%, 54%), but physical exercise programs were less often combined with nutrition (29%, 42%); perceived impact of malnutrition was more about anticancer treatment discontinuation (67%, 28%) than toxicities (44%, 62%); and meetings (42%, 33%) surpass guidelines (44%, 73%) for nutritional decision-making. Concerning HCP specialty, nutritionists (n = 20) estimated the impact of malnutrition 50% less than medical oncologists, and consulted guidelines less (26%, 60%). Surgeons (n = 64) and radiation oncologists (n = 65) judged eligibility for nutritional support and its goals differently than medical oncologists, with less emphasis on weight loss and QoL.
Conclusions
HCP recognition of the impacts of malnutrition and its assessment remains insufficient, while dietary advice is increasing. Our survey data may suggest tailoring nutritional care recommendations at regional and HCP levels.
Clinical trial identification
Legal entity responsible for the study
Nutricia Advanced Medical Nutrition.
Funding
Nutricia Advanced Medical Health.
Editorial Acknowledgement
Medical writing support was provided by Joanne Franklin, PhD, CMPP, from TRM Oncology, The Hague, The Netherlands, and funded by Nutricia Advanced Medical Nutrition.
Disclosure
F. Strasser: Honoraria: Danone, Grünenthal, Helsinn, ISIS Global, Mundipharma, Novartis, Novelpharm, Obexia, Ono Pharmaceutical, Psioxus Therapeutics, Prime Oncology, Sunstone Captial, Vifor; Clinical research industry grants: Celgene, Fresenius, Helsinn. A. O'Callaghan: Corporate-sponsored research: Nutricia Medical; Employee: Nutricia Medical. M.B. Sawyer: Honoraria: Nutricia Advanced Medical Nutrition. S. Kaasa: Stock ownership: Eir Solution. All other authors have declared no conflicts of interest.