NUTRITIONAL ASSESMENT IN ONCOLOGY OUTPATIENTS: A REVIEW OF SCREENING AND ASSESSMENT TOOLS

Abstract

Malnutrition and the associated phenotype of sarcopenia significantly compromise treatment tolerance, increase toxicity risk, and worsen overall survival in cancer patients. Given that the majority of oncological care occurs in the ambulatory setting, systematic nutritional assessment is a critical, mandated component of supportive care. This review synthesizes current evidence to evaluate the optimal screening and assessment tools suitable for routine use in outpatient oncology practice. A comprehensive narrative review was conducted, focusing on recent clinical guidelines and peer-reviewed literature concerning the validation and clinical utility of nutritional assessment instruments. Tools were analyzed across two tiers: Tier 1 (Screening) for feasibility and sensitivity; and Tier 2 (Comprehensive Assessment) for diagnostic accuracy regarding muscle loss and inflammation. The Malnutrition Screening Tool (MST) and Mini Nutritional Assessment Short Form (MNA-SF) emerged as the most practical and sensitive Tier 1 tools for general and geriatric oncology, respectively. For Tier 2, the Patient-Generated Subjective Global Assessment (PG-SGA) remains the gold standard. Crucially, the integration of objective measures—specifically Handgrip Strength and AI-assisted analysis of CT-derived Skeletal Muscle Index (SMI)—is essential for accurately diagnosing sarcopenia. Furthermore, the C-Reactive Protein/Albumin Ratio (CAR) is a powerful biomarker confirming the inflammatory drive of cachexia. Effective nutritional assessment mandates a structured, tiered approach. The reliance on advanced tools for objective body composition analysis is paramount for personalized care. Future efforts must focus on digitalizing this pathway, utilizing AI for automated sarcopenia detection, and ensuring robust resource allocation to oncology dietitians.