Malnutrition risk at diagnosis and influence on survival in patients with solid tumors at a large academic cancer center

6591 Background: Malnutrition is common in cancer patients and negatively impacts quality of life, tolerance to anti-cancer therapies and is associated with poor prognosis. It is, however, unclear if patient-reported malnutrition risk at initial diagnosis is related to overall survival (OS) in solid tumor oncology outpatients in the United States. Methods: A cohort of 3,562 patients who completed the malnutrition screening tool (MST), a validated assessment of malnutrition risk, at initial diagnosis of any stage solid tumor and had available survival data were analyzed. The primary objective was to evaluate the relationship of high malnutrition risk (≥2 of 5 = high risk for malnutrition, H-MST) to OS and was assessed using Kaplan Meier techniques and Cox proportional hazards models. Unadjusted analyses were performed, and adjusted multivariable analyses evaluated the impact of H-MST on OS controlling for key clinical baseline confounders. Results: The median age was 63 years (IQR: 54-71), with 62% females and 81% White. Most common cancer sites were breast (28%), gastrointestinal (GI, 21%), and thoracic (13%) and 80% were non-metastatic. Median follow up was 48.3 months. H-MST was associated with lower OS in the unadjusted model, median OS in months was 32.5 [H-MST] vs not reached in low MST [L-MST] (HR 3.3, 95% CI 2.9-3.7, p = < 0.001). Multivariable analysis confirmed that H-MST remained independently associated with OS when controlling for age, sex, cancer site, stage, BMI, and symptom scores. Landmark OS rates at 50 months were 60% [H-MST] vs. 69% [L-MST] (HR 1.51 95% CI 1.3-1.7, p = < 0.001). Adjusted subgroup analyses by cancer site showed the independent impact of H-MST was relatively similar across groups (Table). Conclusions: High malnutrition risk at initial diagnosis was independently associated with shorter survival across a large representative cohort of solid tumor oncology outpatients. The screening occurred before any anti-cancer therapy and it is noteworthy most had non-metastatic disease. These data highlight the need for systematic screening to identify patients at malnutrition risk who need additional assessment early during cancer. Further research on how to optimize allocation of limited nutrition resources for those with high malnutrition risk is needed. [Table: see text]