Objectives and Purpose
Cancers of the upper-gastrointestinal (UGI) tract, including gastric, oesophageal, and pancreatic cancers are among the most frequently diagnosed cancers globally. Five year survival rates remain low (approximately less than 30%) but are slowly improving due to advances in curative treatments. Treatments for these cancers are often associated with long-term nutrition-related side effects which are frequently under-recognised, under-diagnosed and under-treated, increasing the risk of malnutrition and its associated poor outcomes. This review characterises nutrition impact symptoms that occur following curative-intent treatment for UGI cancers, and evaluates their effects on nutritional status.
Sample and Setting
Four electronic databases were searched to identify studies involving adults who had undergone curative-intent treatment for UGI cancers. Included studies reported nutrition impact symptoms and nutritional outcomes using a validated tool.
Procedure:
A systematic search was conducted, data was extracted, study quality was assessed and results were synthesised narratively.
Results
Eleven studies, involving 953 participants, were included. Participants were predominantly male (68%), and surgery was the primary treatment (91%). Most studies (n=10) used a validated tool to assess nutrition-related symptoms. Reflux was the most frequently reported symptom (n=8 studies). Other common symptoms included abdominal pain (n=6), diarrhoea (n=6) and constipation (n=4). Various validated tools were used to assess malnutrition, including the Patient-Generated Subjective Global Assessment (64% of studies), Mini Nutritional Assessment (18%), Global Leadership Initiative on Malnutrition (9%), and Prognostic Nutritional Index (9%). All studies reported a proportion of participants as malnourished following treatment, ranging from approximately 29-87%.
Conclusion and Clinical Implications
Nutrition impact symptoms are common and persistent following curative treatment for UGI cancers. They can contribute to declining nutritional status and highlight the need for long-term, specialised dietetic support. Validated assessment tools are essential for improving symptom and nutrition status recognition to enhance their management