Real-world nutritional outcomes assessed by subjective global assessment in community oncology practice in western India.

Abstract

e13576 Background: Cancer-related malnutrition affects treatment tolerance & survival, yet real-world data from Western India are limited; this study evaluates nutritional status, predictors of malnutrition & survival using Subjective Global Assessment (SGA). Methods: Cancer patients undergoing SGA between March 2023 - December 2025 were retrospectively analyzed. SGA was performed at baseline & post-intervention evaluating demographic, clinical & survival factors. Binary logistics regression Wilcoxon sign rank test & Kaplan Meier methods were used for analysis. Results: A total of 1155 patients were included who underwent SGA, the median age was 57 years (IQR 47–65) with M:F ratio 1:1.8. The most common cancer types evaluated were breast (30.8%), head & neck (16.4%), gastrointestinal (14.5%), gynaecological (14.9%) & lung cancers (5.6%). Baseline ECOG PS was 0–1 in 77.6%. SGA was conducted at baseline with 90.9% of assessments performed at cycle 1. At baseline, 55.6% of patients were well nourished, 44.2% were mild to moderately malnourished & 0.3% were severely malnourished. Post-intervention [mean duration 6.3 months (1-28)], 60.2% were well nourished & 39.3% were mild to moderately malnourished. Overall nutritional status in malnourished cohort was classified as improved in 57.5% & remained stable in 32.7% while 31.9% (205/642) of initially well-nourished patients deteriorated. SGA deterioration was mainly due to treatment related toxicities in head & neck (17.1%) & gastrointestinal cancers (11.2%) due to dysphagia, dysgeusia, gastrointestinal symptoms & appetite loss. Median pre-SGA score of malnourished cohort was 5 vs 6 post-SGA assessment (p = < 0.001).Male gender was independently associated with higher odds of malnutrition (OR 1.7, 95% CI 1.3–2.1; p < 0.001). Compared to breast cancer, higher malnutrition risk was observed in head & neck (OR 4.2, 95%CI 2.9-6.1),gastrointestinal (OR 3.1, 95%CI 2.1-4.6), lung (OR 4.0, 95% CI 2.3-7.0) & gynecological cancers (OR 1.98, 95% CI 1.4-2.9) (p < 0.001). Improvement rates in malnourished varied by cancer type, with lower improvement observed in head & neck cancer (42.5%) compared with gastrointestinal (69.5%), breast (63.5%), gynecological (61.5%) & lung cancer (55%). Improvements were noted across nutritional domains: disease-related requirements (34.0%), muscle mass (34.4%), fat stores (33.3%), weight loss (32.1%), functional status (29.5%), dietary intake (28.7%) & GI symptoms (20.1%).Median overall survival (mOS) was 84.9 mo at baseline in severe/mild/moderate malnourished patients while mOS was not reached in well-nourished patients (p < 0.001). Conclusions: In this study, SGA effectively identified malnutrition, revealed tumor-specific risk patterns & correlated with survival outcomes underscoring its value as a practical & prognostically informative tool in routine oncology care.