Weight loss in gastrointestinal cancer

3.1. Epidemiology

The prevalence of weight loss and malnutrition in patients with gastrointestinal malignancies ranges from 40% to 87% [44, 45], depending upon tumor site and stage (Table 7.4). The presence of pre-treatment weight loss in patients with GI malignancies is a poor prognostic indicator [46].

Table 7.4 Incidence of Weight Loss in Gastrointestinal Cancer Patients

Site

Percentage

Esophageal

79% [45]

Gastric

83-87% [44]

Pancreatic

83% [44]

Colon

54% [44]

Subjects with advanced GI malignancies often experience large decreases (>50%) in muscle mass and protein content, as well as a 30%-40% loss in body fat [47]. Patients with solid tumors can lose as much as 1.34 kg of fat-free mass in 4 weeks [48]. Changes in body composition seem to affect symptom control and complication rates. Cancer patients with GI malignancies who experience losses of lean body mass have elevated complication rates associated with surgical interventions [49].

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