Malnutrition diagnosed by the Global Leadership Initiative on Malnutrition criteria predicting survival and clinical outcomes of patients with cancer: A systematic review and meta-analysis

The GLIM consensus approach to diagnosis of malnutrition: A 5-year update

BACKGROUND

The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 comprised of screening followed by assessment of three phenotypic criteria: weight loss, low BMI, and low muscle mass, and two etiologic criteria: reduced food intake/assimilation, and inflammation/disease burden. This planned update reconsiders the GLIM framework based on published knowledge and experience over the past five years.

METHODS

A GLIM working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM". Prior GLIM activities providing guidance for use of the criteria on muscle mass and inflammation were reviewed. Successive rounds of review and revision were used to achieve consensus.

RESULTS

More than 400 scientific reports are published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgement may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. Following two rounds of review and revision, the working group secured 100 % agreement with the conclusions reported in the 5-year update.

CONCLUSION

Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.

The Global Leadership Initiative on Malnutrition (GLIM) inflammation criteria to predict survival in patients with advanced cancer: A prospective cohort study

BACKGROUND

The Global Leadership Initiative on Malnutrition (GLIM) criteria provides a framework for assessing cachexia in cancer patients. However, the role of systemic inflammation in this framework needs further exploration.

METHODS

This study analyzed a cohort of 388 advanced cancer patients from 18 oncological care settings. C-reactive protein (CRP), the modified Glasgow Prognostic Score (mGPS) and Neutrophil-to-Lymphocyte Ratio (NLR) were used to assess systemic inflammation. Associations between these inflammatory markers and Weight Loss (WL), Body Mass Index (BMI), Skeletal Muscle Index (SMI), and survival outcomes (OS) were evaluated using Chi-square and Kaplan-Meier survival analyses.

RESULTS

CRP was significantly associated with ECOG-PS (p < 0.01), and WL (p < 0.05). mGPS was significantly associated with ECOG-PS (p < 0.001), WL (p < 0.001), and BMI (p < 0.05). NLR was significantly associated with ECOG-PS (p < 0.05), WL (p < 0.001), and BMI (p < 0.05). CRP (p < 0.001), mGPS (p < 0.001), NLR (p < 0.001), WL (p < 0.001), and SMI (p < 0.05) were significantly associated with OS, but not BMI (p = 0.23). Combining CRP, mGPS, NLR, with WL, BMI, and SMI significantly improved OS prediction. WL was significantly associated with OS in patients with NLR<3 (p < 0.05) but not in CRP≤10 mg/L or mGPS = 0. SMI was significantly associated with OS in patients with mGPS = 0 (p < 0.05).

CONCLUSION

Systemic inflammation, as assessed by CRP, mGPS and NLR, significantly improves the relationship between phenotypic criteria and OS. These findings support the GLIM framework's inclusion of systemic inflammation as a critical factor. Given its strong predictive value, systemic inflammation should be prioritized in routine clinical assessments of cancer patients, with mGPS having greater prognostic value within the GLIM framework.

Prevalence and prognostic value of global leadership initiative on malnutrition (GLIM) phenotypic cachexia criteria in cancer patients: A systematic review and meta-analysis

INTRODUCTION

The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a framework for evaluating cachexia in cancer patients, yet variability in diagnostic application hinders its use. The aim of the present study was to examine the prevalence and prognostic value of GLIM phenotypic criteria in patients with cachexia cancer.

METHODS

This review adhered to a pre-defined protocol. A comprehensive search of PubMed and EMBASE databases was conducted using specific keywords up to June 12, 2024. Titles and abstracts were screened for relevance, and eligible full-text studies focused on the phenotypic criteria of the GLIM framework and their impact on overall survival OS in adult cancer patients. Studies with fewer than 100 patients or lacking OS data were excluded.

RESULTS

Of 477 studies identified 82 met the inclusion criteria (114,458 patients). Lung cancer was the most studied tumour type, followed by gastrointestinal and head and neck cancers. Within the GLIM framework, the prevalence of weight loss (WL) > 5 %, BMI <18.5, BMI <20.0, and lower muscle mass (LMM) were 34.21 %, 10.02 %, 9.51 %, and 41.89 %, respectively. Of the 82 studies, WL, BMI, and LMM were reported in 62 (75.6 %), 57 (69.5 %), and 16 (19.5 %) studies respectively and meta-analysis showed significant associations between phenotypic criteria and OS, with hazard ratios (HR) of 1.56 (1.24; 1.95), 1.18 (1.08; 1.28), and 2.03 (1.32; 3.12) respectively.

CONCLUSION

The present systematic review and meta-analysis highlights the prevalence and prognostic value of GLIM phenotypic criteria in patients with advanced cancer. The limitations of BMI as a phenotypic criterion is clear. Future studies should prioritize and standardise WL measurement and muscle mass assessment within the GLIM framework.

GLIM consensus approach to diagnosis of malnutrition: A 5-year update

BACKGROUND

The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 that comprised screening followed by assessment of three phenotypic criteria (weight loss, low body mass index [BMI], and low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden). This planned update reconsiders the GLIM framework based on published knowledge and experience over the past 5 years.

METHODS

A working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM." Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus.

RESULTS

More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update.

CONCLUSION

Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.

Malnutrition Diagnosed via Global Leadership Initiative on Malnutrition (GLIM) Criteria - Association with Clinical Outcomes and Predictive Value: A Systematic Review of Systematic Reviews

OBJECTIVES

Malnutrition is very common in people with cancer. The Global Leadership Initiative on Malnutrition (GLIM) recommendation on criteria has been proposed as a gold standard for diagnosing malnutrition. The diagnosis of malnutrition includes phenotypic criteria such as unintentional weight loss and etiologic criteria such as reduced food intake. The aim of this review is to summarise the evidence on the GLIM-defined malnutrition association with clinical outcomes and its predictive value.

METHODS

A systematic search was conducted in PubMed, CINAHL, and MEDLINE databases. A total of 6 systematic reviews with and without meta-analysis were identified and included for analysis. Five were systematic reviews with meta-analyses and 1 systematic review without meta-analysis.

RESULTS

GLIM-defined malnutrition is associated with decreased survival, disease-free survival, increased post-operative complications, increased overall complications, and prolonged length of stay. It has predictive value for worsening clinical outcomes.

CONCLUSION

The results support the use of GLIM criteria and indicate their predictive value for clinical outcomes. There is robust evidence indicating the association and predictive value of GLIM-defined malnutrition for clinical outcomes in people with cancer to recommend its use in clinical practice. Thus, the GLIM criteria depend on prior screening tools used and the consistency of muscle mass assessment.

IMPLICATIONS FOR NURSING PRACTICE

Nutrition care is a fundamental aspect of cancer nursing practice and nurses need to be aware of the signs of malnutrition. The GLIM criteria are relevant to be used also in cancer nursing practice for the early detection of malnutrition among people with cancer.

Malnutrition Diagnosed by Patient-Generated Subjective Global Assessment and the Risk of All-Cause Mortality in Adults With Gastrointestinal Cancer: A Systematic Review and Meta-Analysis

INTRODUCTION

Several reviews have highlighted that the Patient-Generated Subjective Global Assessment (PG-SGA) is the best diagnostic tool for assessing nutritional status in cancer patients. However, previous meta-analyses summarizing the prevalence of malnutrition and overall survival in patients with gastrointestinal (GI) cancer are quite limited. This study aims to determine the overall prevalence and association between malnutrition, as defined by the PG-SGA, and mortality in adults with GI cancer.

METHODS

A comprehensive systematic review of articles published from 2005 to 2023 was conducted using Google Scholar, PubMed, Web of Sciences and Scopus. The PRISMA guideline was followed to organize the entire content. A random-effects meta-analysis model using R Studio was performed to quantify the pooled proportion and hazard ratios (HRs). Publication bias was assessed using Egger's test and funnel plots. Heterogeneity was evaluated using I2 and Baujat plots. This study was registered in PROSPERO under the protocol number CRD42023465685.

RESULTS

In this study, 46 publications with 23,235 participants were included in the final meta-analysis. The overall prevalence of malnutrition among adults with GI cancer, as determined by the PG-SGA, was 61% (95% CI: 51%-70%, I2 = 99%). The pooled prevalence of moderate and severe malnutrition were 38% (95% CI: 31%-45%, I2 = 96%) and 21% (95% CI: 13%-31%, I2 = 98%), respectively. By cancer type, malnutrition was more common in patients with oesophageal cancer (78%, 95% CI: 45%-94%, I2 = 99%) and gastric cancer (75%, 95% CI: 68%-81%, I2 = 87%). Additionally, the overall risk (pooled HR) of malnutrition on mortality among GI cancer patients was 2.02 (95% CI: 1.63%-2.5%, I2 = 23%).

CONCLUSION

Malnutrition is common in adults with GI cancer and doubles the risk of all-cause mortality. These results emphasize the importance of ongoing efforts in prevention, early assessment, and intervention for malnutrition to minimize mortality rates.

A scoping review of diet and exercise interventions for older cancer survivors' physical function

Lifestyle (diet and exercise) interventions across the cancer care continuum among younger cancer survivors (<60 years of age) demonstrate utility in improving physical function, and other cancer relevant health outcomes. However, the impact of lifestyle interventions on physical function in older (≥60 years) cancer survivors is not entirely clear. This scoping review aims to map and characterize the existing literature on the effect of diet and exercise interventions on physical function in older cancer survivors. Conducted to the JBI Manual for Evidence Synthesis and reported to the PRISMA guidelines, the literature search was performed on multiple databases through March 2024. A total of 19,901 articles were identified for screening with 49 articles published between 2006 and 2024 selected for full-text review. Of these, 36 studies included an exercise intervention, two focused on diet intervention, while 11 studies included both diet and exercise intervention. These 49 studies included various cancer types, cancer stages, and timepoints across the cancer care continuum. Most studies described physical function as their primary outcome and demonstrated maintenance or improvement in physical function. We identified several gaps in the current evidence including lack of (adequately powered) trials focused only on older cancer survivors, and trials focused on dietary interventions alone or dietary interventions combined with exercise interventions within this population vulnerable for nutritional inadequacies and declining physical function. Considering the growing population of older cancer survivors, this represents an important area for further research.

Comparative Study of Different Inflammation Definition Methods of GLIM in the Diagnosis of Malnutrition in Patients with Acute Pancreatitis

Purpose

This study aims to investigate the influence of the Global Leadership Initiative on Malnutrition (GLIM) on diagnosing malnutrition in acute pancreatitis (AP) based on various inflammatory criteria.

Patients and Methods

A total of 258 AP patients admitted to a large medical center between June 2019 and January 2022 were retrospectively analyzed. All patients underwent evaluation using the original GLIM and GLIM criteria based on C-reactive protein (CRP), albumin, neutrophil/lymphocyte ratio, and CRP/albumin ratio (CAR). The study explored the impact of malnutrition diagnosis using different GLIM criteria on various clinical outcomes of AP patients and assessed the agreement of different GLIM criteria compared to the original GLIM.

Results

Thirty-seven (14.34%) patients were malnourished according to the original GLIM criteria. Using the other four criteria, malnutrition rates ranged from 6.59% to 12.40%. Malnutrition diagnosed by all GLIM criteria was associated with local complications. Malnutrition identified by the original, CRP-based, and CAR-based GLIM criteria was also associated with infectious complications and composite outcomes. Meanwhile, albumin-based malnutrition was associated with all adverse outcomes except organ failure. When considering all four GLIM criteria except the original one, malnourished patients exhibited longer lengths of stay than non-malnourished patients. Under the CRP- and albumin-based GLIM criteria, hospitalization costs were higher for malnourished patients. The sensitivity analyses demonstrated the robustness of the results. The agreement of the four GLIM criteria with the original GLIM criteria were consistent with the corresponding incidence of malnutrition.

Conclusion

This study validated the GLIM criteria for the first time in AP. Malnourished patients were more likely to experience local complications than non-malnourished AP patients. However, the inconsistency between GLIM criteria based on disease burden and various inflammatory markers was significant. The inflammatory marker-based GLIM criteria demonstrated a stronger predictive value than the original GLIM criteria in assessing prognosis in AP patients.

Global Leadership Initiative on Malnutrition-defined malnutrition coexisting with visceral adiposity predicted worse long-term all-cause mortality among inpatients with decompensated cirrhosis

BACKGROUND/OBJECTIVES

Malnutrition coexisting with abdominal adipose tissue accumulation bring a double burden on prognosis. More recently, the Global Leadership Initiative on Malnutrition (GLIM) has reached a novel consensus concerning the diagnostic criteria, that is, a two-step modality combining nutritional risk screening and subsequent phenotypic/etiologic parameters for comprehensive evaluation in hopes of harmonizing the malnutrition diagnosis. We aimed to elucidate their synergistic impact among inpatients with decompensated cirrhosis concerning long-term mortality.

SUBJECTS/METHODS

Malnutrition, visceral obesity, and visceral adiposity were defined by the Global Leadership Initiative on Malnutrition (GLIM), visceral fat area (VFA), and visceral to subcutaneous adipose tissue area ratio (VSR) on computed tomography, respectively. Accordingly, the patients were categorized into different groups given their nutritional status and visceral obesity/adiposity. Multivariate Cox regression was performed to identify independent risk factors associated with 1-year all-cause mortality. Kaplan-Meier curves with log-rank tests were compared among distinct groups.

RESULTS

Totally, 295 patients were recruited. GLIM, VFA, and VSR identified 131 (44.4%), 158 (53.6%), and 59 (20%) patients with malnutrition, visceral obesity and visceral adiposity, respectively. Malnutrition coexisted with visceral obesity in 55 (MO group) relative to visceral adiposity in 40 patients (MA group). Multivariate Cox analysis showed that MA (hazard ratio: 2.48; 95% confidence interval: 1.06, 5.79; P = 0.036) was independently associated with dire outcome rather than MO. Moreover, patients with cirrhosis in the MA group had the worst survival status when compared with other groups (log-rank test: P < 0.001).

CONCLUSIONS

The current study indicated that coexisting GLIM-defined malnutrition and VSR-defined visceral adiposity were in relation to worse long-term mortality among inpatients. It is imperative to delicately manage nutritional status and provide personalized treatment in this vulnerable subgroup for achieving better prognosis.

Validation of the Global Leadership Initiative on Malnutrition Criteria for Predicting Adverse Outcomes in Acute Pancreatitis

Background and Aim

The Global Leadership Initiative on Malnutrition (GLIM) has proposed criteria for the diagnosis of malnutrition. No studies validated the GLIM criteria in acute pancreatitis (AP). The present study aimed to validate the predictive capacity of GLIM criteria for adverse outcomes in AP patients.

Patients and Methods

Clinical data of 269 patients with AP were analyzed retrospectively. The Nutritional Risk Screening 2002 (NRS2002) was chosen as the screening tool. Multivariate logistic regression analyses evaluated the adverse clinical outcomes in malnourished patients.

Results

Overall, 160 patients (59.5%) were at nutritional risk and 38 (14.1%) were malnourished. Reduced muscle mass/ low body mass index + inflammation combinations contributed most to malnutrition overall and in each subgroup. The malnourished group had lower hemoglobin, neutrophils, albumin, total cholesterol, and triglycerides than the well-nourished group. The malnourished group had higher hospitalization costs (CNY, 11319.34 vs 9258.22, p <0.001) and more local complications (34.2% vs 14.7%, p =0.009) than the well-nourished group. There was an interaction between malnutrition and overweight/obesity on local complications (p for interaction = 0.023). Multivariate logistic regression showed malnutrition was significantly associated with local complications (OR 12.2, 95% CI: 2.51-59.37), infectious complications (OR 9.95, 95% CI: 1.25-79.44) and composite adverse outcome (OR 4.78, 95% CI: 1.05-21.73) in the overweight/obesity subgroup. There was no association between malnutrition and the rate of various adverse outcomes in the non-overweight/obesity subgroup. Additionally, we observed an association between malnutrition and composite adverse outcome (OR 6.75, 95% CI: 1.49-30.68) in patients <70 years only in females.

Conclusion

Malnourished AP patients were more likely to have adverse outcomes than well-nourished patients. Malnutrition was associated with various adverse outcomes only in the overweight/obesity subgroups.

Performance of anthropometry-based and bio-electrical impedance-based muscle-mass indicators in the Global Leadership Initiative on Malnutrition criteria for predicting prognosis in patients with cancer

BACKGROUND

Reduced muscle mass is a criterion for diagnosing malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria; however, the choice of muscle-mass indicators within the GLIM criteria remains contentious. This study aimed to establish muscle-measurement-based GLIM criteria using data from bio-electrical impedance analysis (BIA) and anthropometric evaluations and evaluate their ability to predict overall survival (OS), short-term outcomes, and healthcare burden in patients with cancer.

METHODS

This was a multicenter, prospective study that commenced in 2013 and enrolled participants from various clinical centers across China. We constructed GLIM criteria based on various muscle measurements, including fat-free mass index (FFMI), skeletal muscle index (SMI), calf circumference (CC), midarm circumference (MAC), midarm muscle circumference (MAMC), and midarm muscle area (MAMA). Survival was estimated using the Kaplan-Meier method and survival curves were compared using the log-rank test. Cox proportional hazards regression was used to assess the independent association between the GLIM criteria and OS. The discriminatory performance of different muscle-measurement-based GLIM criteria for mortality was evaluated using Harrell's concordance index (C-index). Logistic regression was used to evaluate the association of the GLIM criteria with short-term outcomes and healthcare burden.

RESULTS

A total of 4769 patients were included in the analysis, of whom 1659 (34.8%) died during the study period. The Kaplan-Meier curves demonstrated that all muscle-measurement-based GLIM criteria significantly predicted survival in patients with cancer (all p < 0.001). The survival rate of malnourished patients was approximately 10% lower than that of non-malnourished patients. Cox proportional hazards regression showed that all the muscle-measurement-based GLIM could independently predict the OS of patients (all p < 0.001). The prognostic discrimination was as follows: MAMC (Chi-square: 79.61) > MAMA (Chi-square: 79.10) > MAC (Chi-square: 64.09) > FFMI (Chi-square: 62.33) > CC (Chi-square: 58.62) > ASMI (Chi-square: 57.29). In comparison to the FFMI-based GLIM criteria, the ASMI-based criteria (-0.002, 95% CI: -0.006 to 0.002, p = 0.334) and CC-based criteria (-0.003, 95% CI: -0.007 to 0.002, p = 0.227) did not exhibit a significant advantage. However, the MAC-based criteria (0.001, 95% CI: -0.003 to 0.004, p = 0.776), MAMA-based criteria (0.004, 95% CI: 0.000-0.007, p = 0.035), and MAMC-based criteria (0.005, 95% CI: 0.000-0.007, p = 0.030) outperformed the FFMI-based GLIM criteria. Logistic regression showed that muscle measurement-based GLIM criteria predicted short-term outcomes and length of hospital stay in patients with cancer.

CONCLUSION

All muscle measurement-based GLIM criteria can effectively predict OS, short-term outcomes, and healthcare burden in patients with cancer. Anthropometric measurement-based GLIM criteria have potential for clinical application as an alternative to BIA-based measurement.

A survey of preoperative surgical nutrition practices, opinions, and barriers across Canada

Malnutrition is prevalent among surgical candidates and associated with adverse outcomes. Despite being potentially modifiable, malnutrition risk screening is not a standard preoperative practice. We conducted a cross-sectional survey to understand healthcare professionals' (HCPs) opinions and barriers regarding screening and treatment of malnutrition. HCPs working with adult surgical patients in Canada were invited to complete an online survey. Barriers to preoperative malnutrition screening were assessed using the Capability Opportunity Motivation-Behaviour model. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using summative content analysis. Of the 225 HCPs surveyed (n = 111 dietitians, n = 72 physicians, n = 42 allied HCPs), 96%-100% agreed that preoperative malnutrition is a modifiable risk factor associated with worse surgical outcomes and is a treatment priority. Yet, 65% (n = 142/220; dietitians: 88% vs. physicians: 40%) reported screening for malnutrition, which mostly occured in the postoperative period (n = 117) by dietitians (n = 94). Just 42% (48/113) of non-dietitian respondents referred positively screened patients to a dietitian for further assessment and treatment. The most prevalent barriers for malnutrition screening were related to opportunity, including availability of resources (57%, n = 121/212), time (40%, n = 84/212) and support from others (38%, n = 80/212). In conclusion, there is a gap between opinion and practice among surgical HCPs pertaining to malnutrition. Although HCPs agreed malnutrition is a surgical priority, the opportunity to screen for nutrition risk was a great barrier.

Global Leadership Initiative on Malnutrition (GLIM) for the diagnosis of malnutrition - a framework for consistent dietetic practice

Malnutrition is an alarming and ongoing healthcare problem globally. Malnutrition has a negative impact on the individual patient, leading to poorer clinical outcomes and increased mortality, but also poses an economic burden on society. Proper identification and diagnostics are prerequisites for initiation of treatment. In 2019, the Global Leadership Initiative on Malnutrition, a consensus-based global framework to uniformly diagnose malnutrition across populations, healthcare settings, and countries was published. Identifying and treating malnutrition is an interdisciplinary team effort. Nonetheless, the nutrition and dietetics profession is specifically trained for diagnosing and treating nutrition(-related) conditions, and therefore has a key role in the interdisciplinary team in implementing the GLIM framework in clinical practice. For the nutrition and dietetics profession, GLIM offers a great opportunity for moving both the scientific and clinical knowledge of malnutrition management forward. While the GLIM framework has been extensively studied since its launch, various knowledge gaps still remain. For the nutrition and dietetics profession, these knowledge gaps mainly relate to the GLIM implementation process, to the role of GLIM in relation to the nutrition care process, and to treatment strategies for various nutrition-related conditions. In this opinion paper, we aimed to describe the rationale for implementing the GLIM framework in clinical dietetic practice, and propose a research agenda based on knowledge gaps regarding GLIM in relation to nutrition care from a dietetic point of view.

Nutritional Assessment Tools for Patients with Cancer: A Narrative Review

Cancer patients are at high risk of malnutrition, which can lead to adverse health outcomes such as prolonged hospitalization, increased complications, and increased mortality. Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients. However, while many tools exist to assess malnutrition, there is no universally accepted standard. Although different tools have their own strengths and limitations, there is a lack of narrative reviews on nutritional assessment tools for cancer patients. To address this knowledge gap, we conducted a non-systematic literature search using PubMed, Embase, Web of Science, and the Cochrane Library from their inception until May 2023. A total of 90 studies met our selection criteria and were included in our narrative review. We evaluated the applications, strengths, and limitations of 4 commonly used nutritional assessment tools for cancer patients: the Subjective Global Assessment (SGA), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA), and Global Leadership Initiative on Malnutrition (GLIM). Our findings revealed that malnutrition was associated with adverse health outcomes. Each of these 4 tools has its applications, strengths, and limitations. Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients. It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.