Objetivo: Avaliar o estado nutricional de pacientes admitidos para início do tratamento no Instituto do Câncer do Estado de São Paulo (ICESP). Metodologia: Estudo de coorte, transversal, prospectivo, incluindo adultos com tumor sólido, entre abril de 2015 e setembro de 2017. A avaliação nutricional incluiu: a) avaliação subjetiva global produzida pelo paciente (ASG-PPP); b) Composição corporal (medidas antropométricas e de bioimpedância elétricaBIA). Resultado: Foram incluídos 696 pacientes, com mediana de 60 (51-67) anos, homens 50.4%. Tumores de mama (26%), do trato genital masculino (21.4%) e do trato gastrointestinal (18.8%) foram os mais frequentes. ECOG entre 0 e 1 e metástase foram observados em 94.9% e 14.7% dos pacientes, respectivamente. O estado nutricional dos pacientes foi diverso, sendo a maioria eutrófico (32.5%) ou acima do peso (59%) pelo Índice de Massa Corporal (IMC) e bem nutridos pela ASG-PPP (86.6%). Os sinais de prejuízo nutricional mais frequentes foram: redução na ingesta alimentar (24.7%); perda de peso grave (PPG) em um (14.2%) e seis meses (22.7%); redução do tecido muscular pela Área Muscular Braço (AMB)(9.8%); Ângulo de fase padronizado (AFP)<-1.65 (11.2%); déficit muscular pelo Índice de Massa Livre de Gordura (IMLG)(11.9%). Escore4 pela ASG-PPP e caquexia foram observados em 58.5% e 32,5%, respectivamente. Pacientes com IMC em eutrofia, sobrepeso e obesidade apresentaram PPG no último mês em 33.9%,31% e 20.2% dos casos, respectivamente. Desnutrição e escore4 pela ASG-PPP foram observados nos pacientes eutróficos (18.1% e 58%, respectivamente), com sobrepeso (7.1% e 50.8%, respectivamente) e nos obesos (3.4% e 63%, respectivamente). Pacientes em eutrofia, sobrepeso e obesidade apresentaram caquexia em 38.5%, 25.1% e 25% dos casos, respectivamente. Pacientes com AFP<-1.65DP, quando comparados aos com -1.65 DP apresentaram pela ASG-PPP maior frequência de desnutridos (42.3% vs. 9.7%, p<0.001), de abaixo do peso pelo IMC (24.2% vs. 6.5%, p<0.001), de PPG no último mês (24.4% vs. 12.9%, p=0.007) de déficit muscular pela AMB (26.9% vs. 7.6%, p<0.001), de IMLG (24.4% vs. 10.4%, P<0.001) e de caquexia (61.5% vs. 28.8%, p<0.001). Quando comparados aos não idosos, os idosos apresentaram maior frequência de desnutrição (16.9% vs. 9.6%, p=0.016) e escore9 (24.9% vs. 18.2%, p=0.032) pela ASG-PPP, déficit muscular pelo IMLG (16.9% vs. 6.6%, p<0.001), caquexia (36% vs. 28.7%, p=0.038) e menor AFP (-0.39[-1.16-0.35] vs.-0.28[-1.05-0.58, p=0.027). Quando comparados aos sem DRC, os pacientes com DRC apresentaram pela ASG-PPP maior frequência de desnutrição (23.3% vs.11.4%, p=0.003) e escore4 (70.7% vs. 56.1%, p=0.009), de déficit muscular (AMB)(17.2% vs. 8.3%, p=0.002) e (IMLG)(20.7% vs. 10.2%, p=0.001), de AFP<-1.65 (19.8% vs. 9.5%, p=0.001) e de caquexia (42.2% vs. 30.5%, p=0.014). Pacientes com tumor de cabeça e pescoço, do trato gastrointestinal e tórax apresentaram maior percentual de abaixo do peso (IMC)(11.4%,11.5% e 13%, respectivamente) e desnutrição (ASG-PPP)(34.3%,21.3% e 26.1%, respectivamente). Conclusão: O perfil dos pacientes foi diverso. Independentemente do estado nutricional avaliado pelo IMC e ASG-PPP, muitos pacientes apresentaram baixa ingesta alimentar, PPG, redução no IMLG, AMB, e no AFP, além de caquexia. Esses achados sugerem o benefício de uma avaliação nutricional precoce e abrangente em pacientes oncológicos ao início do tratamento oncológico

Objective: To evaluate the nutritional status of patients admitted for treatment at Instituto do Cancer do Estado de São Paulo (ICESP). Methodology: Prospective cross-sectional cohort study, including adult patients with solid tumor between April 2015 and September 2017. The nutritional assessment included: a) subjective global assessment produced by the patient (PG-SGA); b) Body composition (anthropometric and bioelectrical impedance measurements BIA). Result: 696 patients were included, with a median of 60 (51-67) years, men 50.4%. Tumors of the breast (26%), male genital tract (21.4%) and gastrointestinal tract (18.8%) were the most frequent. ECOG between 0 and 1 and metastasis were observed in 94.9% and 14.7% of patients, respectively. Patients nutritional status was diverse, with the majority being eutrophic (32.5%) or overweight (59%) by the Body Mass Index (BMI) and well nourished by the PG-SGA (86.6%). The most frequent signs of nutritional impairment were: reduced food intake (24.7%); severe weight loss (SWL) at one (14.2%) and six months (22.7%); reduction of muscle tissue by the Arm Muscular Area (AMA) (9.8%); Standardized phase angle (SPA)<-1.65 (11.2%); muscle deficit by the Fat Free Mass Index (FMI)(11.9%). PG-SGA score 4 and cachexia were observed in 58.5% and 32.5%, respectively. Eutrophic, overweight, and obese BMI patients had SWL in the last month in 33.9%, 31% and 20.2% of cases, respectively. Malnutrition and PG-SGA score 4 was observed in eutrophic patients (18.1% and 58%, respectively), overweight (7.1% and 50.8%, respectively) and obese (3.4% and 63%, respectively). Eutrophic, overweight, and obese patients presented cachexia in 38.5%, 25.1% and 25% of cases, respectively. Patients with SPA <-1.65 standard deviation (SD), when compared to those with -1.65 SD, showed a higher frequency of malnourished (42.3% vs. 9.7%, p<0.001) by PG-SGA, of underweight by BMI (24.2% vs. 6.5% p<0.001), of SWL in the last month (24.4% vs. 12.9%, p=0.007) of muscle deficit by AMA (26.9% vs. 7.6%, p<0.001), of IFFM (24.4% vs. 10.4 %, P<0.001) and cachexia (61.5% vs. 28.8%, p<0.001). When compared to the non-elderly, elderly patients had a higher frequency of malnutrition (16.9% vs. 9.6%, p=0.016) and a score 9 (24.9% vs. 18.2%, p=0.032) by the PG-SGA, muscle deficit by the IFFM (16.9% vs. 6.6%, p<0.001), of cachexia (36% vs. 28.7%, p=0.038) and lower SPA (-0.39[-1.16-0.35] vs.-0.28[-1.05-0.58, p= 0.027). When compared to those without CKD, patients with CKD presented a higher frequency of malnutrition (23.3% vs.11.4%, p=0.003) and a score 4 (70.7% vs. 56.1%, p=0.009) by the PG-SGA, muscle deficit (AMA)(17.2% vs. 8.3%, p=0.002) and (IFFM) (20.7% vs. 10.2%, p=0.001), of SPA<-1.65 (19.8% vs. 9.5%, p=0.001) and of cachexia (42.2% vs. 30.5%, p=0.014). Patients with tumors of head and neck, gastrointestinal tract and thorax had a higher frequency of underweight (BMI) (11.4%, 11.5% and 13%, respectively), and malnutrition (PG-SGA) (34.3%, 21.3% and 26.1%, respectively). Conclusion: Nutritions profile was diverse. Regardless of nutritional status assessed by BMI and PG-SGA, many patients had low food intake, SWL, reduced IFFM, AMA, and SPA, in addition to cachexia. These findings suggest the benefit of an early and comprehensive nutritional assessment in cancer patients at the beginning of cancer treatment