Baseline nutritional evaluation in metastatic lung cancer patients: Mini Nutritional Assessment versus weight loss history

Background: Cancer cachexia adversely affects survival and quality of life but its timely recognition is problematic. Nutritional questionnaires, like the Mini Nutritional Assessment (MNA), could identify early those patients at risk. The aim of the study was to compare MNA with 5% weight loss, a common criterion used in oncologic evaluation. Patients and methods: The nutritional status of 171 chemotherapy-naive patients with metastatic lung cancer was evaluated by both methods. The results were compared and correlated with clinical and laboratory values and with clinical outcome. Results: The incidence of malnourished or patients at risk was higher according to the MNA (P < 0.001). Both methods correlated with the performance status (P < 0.001) but MNA was further correlated with the number of metastatic sites (P = 0.007) and the presence of brain metastasis (P = 0.022). Of 14 laboratory values studied, 9 were correlated with MNA and 5 with the weight loss history. Both methods were correlated with response to first-line therapy, time to progression and survival but MNA had a better predictive (P < 0.001) and prognostic (P < 0.001) value. Conclusions: MNA outperforms weight loss history as a baseline nutritional screening method in patients with metastatic lung cancer and could further refine prognostication.