Assessment of tools for the diagnosis of malnutrition and overall survival in adults diagnosed with oral squamous cell carcinoma: A comparison study.

Abstract

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria have been suggested for use in clinical practice for multiple tumor types, but there are currently no data on the effectiveness of tools for the diagnosis of malnutrition in patients with oral squamous cell carcinoma.

Methods: A retrospective study was conducted including 317 patients who underwent radical surgery for oral squamous cell carcinoma between October 2021 and May 2024. Six preoperative nutrition assessment tools were included: the GLIM criteria, Patient-Generated Subjective Global Assessment, European Society for Clinical Nutrition and Metabolism criteria, Prognostic Nutritional Index, Nutritional Risk Index, and body mass index.

Results: Multivariate Cox proportional hazards models indicated that severe malnutrition identified by GLIM (hazard ratio [HR], 2.10; 95% CI, 1.01-4.36; P = 0.04) and the GLIM subcriteria combination of weight loss and cancer (HR, 7.30; 95% CI, 2.98-17.89; P < 0.001) were independent predictors of overall survival. The GLIM subcriteria combination of weight loss and cancer (Brier score, 0.096; C statistics [0.80; 95% CI, 0.74-0.85]) had the best predictive performance for overall survival.

Conclusion: The GLIM criteria have predictive value for diagnosing preoperative malnutrition in patients with oral squamous cell carcinoma. However, the GLIM subcriteria combination of weight loss and cancer offers greater advantages in prognostic prediction and may be useful for risk stratification and guidance for nutrition interventions in patients with oral squamous cell carcinoma.