Natalia Russo

Body composition (BC) analysis may integrate assessment of nutritional risk in patients with gastrointestinal cancers. Applying unsupervised machine learning techniques, we derived BC profiles (BCPs) and investigated their association with malnutrition risk and quality of life. This cross-sectional analysis includes gastrointestinal cancer patients enrolled in the NUTRItional and sarcopenia SCREENing project, part of the ONCOCAMP study (ClinicalTrials.gov ID: NCT06270602). Malnutrition assessment was performed using the NRS-2002, anthropometry and BC analysis; HRQoL was evaluated with the EORTC QLQ-C30 questionnaire. Principal component analysis and k-means clustering identified BCPs. Data from 189 patients (mean age: 66.3 ± 11.2 years) with gastric (37%), pancreatic (26.5%), rectal (24.3%) and hepatocellular carcinoma (12.2%) were analyzed. Overall, 36.5% of patients were at nutritional risk (NRS-2002 ≥ 3). Two BC clusters, High Muscle Profile (HMP) and Low Muscle Profile (LMP), were derived. Although no statistically significant association was observed in the overall cohort, multivariable analysis stratified by gender identified an association between LMP and nutritional risk among male patients (OR = 3.77, 95% CI: 1.08–14.3, p = 0.042); however, this finding should be considered exploratory. Nutritional risk, but not BC profiles, was associated with poorer Summary Score (β = 8.0, 95% CI: −14 to −2.3, p = 0.007) and higher Symptom Score (β = 9.8, 95% CI:4.5 to 15, p < 0.001). These preliminary results warrant further confirmation in larger, adequately powered longitudinal cohorts. Future studies should determine whether BCPs provide additional value beyond established nutritional screening and individual BC parameters in clinical practice.

Background/Objectives: Cancer and their treatments could impact physical, nutritional, and psychological health, negatively influencing overall well-being. Accordingly, Health-Related Quality of Life (HRQoL) could be influenced by lifestyle habits, such as physical activity. This study aimed to assess physical activity levels in patients with a primary cancer diagnosis and their association with HRQoL at the first nutritional assessment. Methods: Data from the NUTRISCREEN project, part of the ONCOCAMP study (ClinicalTrials.gov ID: NCT06270602), were analyzed. Nutritional and sarcopenia risk, anthropometry and body composition parameters were collected. HRQoL and physical activity (as MET levels) were assessed through validated questionnaires. Descriptive statistics summarized categorical and continuous variables, and multivariable ordinal logistic regression models were performed. Results: Nutritional and sarcopenia risk decreased progressively with higher MET levels (p = 0.005 and p < 0.001, respectively). Adjusted multivariable models showed that HRQoL functional scores improved with increasing MET levels, with significant positive trends for physical (p < 0.001), role (p < 0.001), emotional (p = 0.003), and social functioning (p = 0.001), and global health status (p < 0.001). Conversely, symptom burden, including fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, and constipation, decreased across MET quartiles (all p < 0.05). Conclusions: Overall, our findings suggest that physical activity may positively influence HRQoL among cancer patients. Early assessment helps to identify patients at risk of inactivity and support tailored rehabilitation programs to promote active lifestyles, preserve muscle mass, improve outcomes and overall health status.