ESPEN practical guideline: Clinical Nutrition in cancer

Maurizio Muscaritoli; Jann Arends; Patrick Bachmann; Vickie Baracos; Nicole Barthelemy; Hartmut Bertz; Federico Bozzetti; Elisabeth Hütterer; Elizabeth Isenring; Stein Kaasa; Zeljko Krznaric; Barry Laird; Maria Larsson; Alessandro Laviano; Stefan Mühlebach; Line Oldervoll; Paula Ravasco; Tora S. Solheim; Florian Strasser; Marian de van der Schueren; Jean-Charles Preiser; Stephan C. Bischoff

doi:10.1016/j.clnu.2021.02.005

ESPEN practical guideline: Clinical Nutrition in cancer

Maurizio Muscaritoli^*, Jann Arends, Patrick Bachmann, Vickie Baracos, Nicole Barthelemy, Hartmut Bertz, Federico Bozzetti, Elisabeth Hütterer, Elizabeth Isenring, Stein Kaasa, Zeljko Krznaric, Barry Laird, Maria Larsson, Alessandro Laviano, Stefan Mühlebach, Line Oldervoll, Paula Ravasco, Tora S. Solheim, Florian Strasser, Marian de van der SchuerenJean-Charles Preiser, Stephan C. Bischoff

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients. Methods: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with cancer. Results: A total of 43 recommendations are presented with short commentaries for the nutritional and metabolic management of patients with neoplastic diseases. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in cancer patients. Conclusion: This practical guideline gives guidance to health care providers involved in the management of cancer patients to offer optimal nutritional care.

Original language	English
Pages (from-to)	2898-2913
Number of pages	16
Journal	Clinical Nutrition
Volume	40
Issue number	5
DOIs	https://doi.org/10.1016/j.clnu.2021.02.005
Publication status	Published - 1 May 2021

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10.1016/j.clnu.2021.02.005

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Muscaritoli, M., Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., Hütterer, E., Isenring, E., Kaasa, S., Krznaric, Z., Laird, B., Larsson, M., Laviano, A., Mühlebach, S., Oldervoll, L., Ravasco, P., Solheim, T. S., Strasser, F., ... Bischoff, S. C. (2021). ESPEN practical guideline: Clinical Nutrition in cancer. Clinical Nutrition, 40(5), 2898-2913. https://doi.org/10.1016/j.clnu.2021.02.005

@article{873bd45f7343434ea82c8cee6124687e,

title = "ESPEN practical guideline: Clinical Nutrition in cancer",

abstract = "Background: This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients. Methods: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with cancer. Results: A total of 43 recommendations are presented with short commentaries for the nutritional and metabolic management of patients with neoplastic diseases. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in cancer patients. Conclusion: This practical guideline gives guidance to health care providers involved in the management of cancer patients to offer optimal nutritional care.",

keywords = "Anorexia, Cachexia, Cancer, Chemotherapy, Malnutrition, Radiotherapy",

author = "Maurizio Muscaritoli and Jann Arends and Patrick Bachmann and Vickie Baracos and Nicole Barthelemy and Hartmut Bertz and Federico Bozzetti and Elisabeth H{\"u}tterer and Elizabeth Isenring and Stein Kaasa and Zeljko Krznaric and Barry Laird and Maria Larsson and Alessandro Laviano and Stefan M{\"u}hlebach and Line Oldervoll and Paula Ravasco and Solheim, {Tora S.} and Florian Strasser and {de van der Schueren}, Marian and Jean-Charles Preiser and Bischoff, {Stephan C.}",

note = "Funding Information: The development of this guideline was supported by ESPEN , EPAAC , and UEG . Funding Information: The present practical guideline consists of 43 recommendations and is based on European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines on nutrition in cancer patients [ 1 ]. The original guideline was shortened by restricting the commentaries to the gathered evidence and literature on which the recommendations are based on. The recommendations were not changed but the presentation of the content was transformed into a graphical presentation consisting of decision-making flow charts wherever possible. The original guideline was developed based on the ESPEN framework for disease-specific guidelines [ 2 ] and topics to be covered were decided through several rounds of discussion and modification, searching for meta-analyses, systematic reviews and comparative studies based on clinical questions according to the PICO format. The evidence was evaluated and merged to develop clinical recommendations using the GRADE method. All recommendations were not only based on evidence but also underwent a consensus process, which resulted in a percentage of agreement (%). Whenever possible, representatives from different professions (physicians, dieticians, nurses, others) as well as patient representatives were involved. Members of the guideline group were selected by ESPEN to include a range of professions and fields of expertise. The guideline process was commissioned and financially supported by ESPEN and by the European Partnership for Action Against Cancer (EPAAC), an EU level initiative. The guideline shortage and dissemination was funded in part by the United European Gastroenterology (UEG) society, and also by the ESPEN society. For further details on methodology, see the full version of the ESPEN guideline [ 1 ] and the ESPEN framework for disease-specific guidelines [ 2 ]. The ESPEN practical guideline “Clinical Nutrition in Cancer” has been structured according to a flow chart covering all nutritional aspects of cancer ( Fig. 1 ). Publisher Copyright: {\textcopyright} 2021 European Society for Clinical Nutrition and Metabolism Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = may,

day = "1",

doi = "10.1016/j.clnu.2021.02.005",

language = "English",

volume = "40",

pages = "2898--2913",

journal = "Clinical Nutrition",

issn = "0261-5614",

publisher = "Churchill Livingstone",

number = "5",

}

Muscaritoli, M, Arends, J, Bachmann, P, Baracos, V, Barthelemy, N, Bertz, H, Bozzetti, F, Hütterer, E, Isenring, E, Kaasa, S, Krznaric, Z, Laird, B, Larsson, M, Laviano, A, Mühlebach, S, Oldervoll, L, Ravasco, P, Solheim, TS, Strasser, F, de van der Schueren, M, Preiser, J-C & Bischoff, SC 2021, 'ESPEN practical guideline: Clinical Nutrition in cancer', Clinical Nutrition, vol. 40, no. 5, pp. 2898-2913. https://doi.org/10.1016/j.clnu.2021.02.005

TY - JOUR

T1 - ESPEN practical guideline: Clinical Nutrition in cancer

AU - Muscaritoli, Maurizio

AU - Arends, Jann

AU - Bachmann, Patrick

AU - Baracos, Vickie

AU - Barthelemy, Nicole

AU - Bertz, Hartmut

AU - Bozzetti, Federico

AU - Hütterer, Elisabeth

AU - Isenring, Elizabeth

AU - Kaasa, Stein

AU - Krznaric, Zeljko

AU - Laird, Barry

AU - Larsson, Maria

AU - Laviano, Alessandro

AU - Mühlebach, Stefan

AU - Oldervoll, Line

AU - Ravasco, Paula

AU - Solheim, Tora S.

AU - Strasser, Florian

AU - de van der Schueren, Marian

AU - Preiser, Jean-Charles

AU - Bischoff, Stephan C.

N1 - Funding Information: The development of this guideline was supported by ESPEN , EPAAC , and UEG . Funding Information: The present practical guideline consists of 43 recommendations and is based on European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines on nutrition in cancer patients [ 1 ]. The original guideline was shortened by restricting the commentaries to the gathered evidence and literature on which the recommendations are based on. The recommendations were not changed but the presentation of the content was transformed into a graphical presentation consisting of decision-making flow charts wherever possible. The original guideline was developed based on the ESPEN framework for disease-specific guidelines [ 2 ] and topics to be covered were decided through several rounds of discussion and modification, searching for meta-analyses, systematic reviews and comparative studies based on clinical questions according to the PICO format. The evidence was evaluated and merged to develop clinical recommendations using the GRADE method. All recommendations were not only based on evidence but also underwent a consensus process, which resulted in a percentage of agreement (%). Whenever possible, representatives from different professions (physicians, dieticians, nurses, others) as well as patient representatives were involved. Members of the guideline group were selected by ESPEN to include a range of professions and fields of expertise. The guideline process was commissioned and financially supported by ESPEN and by the European Partnership for Action Against Cancer (EPAAC), an EU level initiative. The guideline shortage and dissemination was funded in part by the United European Gastroenterology (UEG) society, and also by the ESPEN society. For further details on methodology, see the full version of the ESPEN guideline [ 1 ] and the ESPEN framework for disease-specific guidelines [ 2 ]. The ESPEN practical guideline “Clinical Nutrition in Cancer” has been structured according to a flow chart covering all nutritional aspects of cancer ( Fig. 1 ). Publisher Copyright: © 2021 European Society for Clinical Nutrition and Metabolism Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/5/1

Y1 - 2021/5/1

N2 - Background: This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients. Methods: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with cancer. Results: A total of 43 recommendations are presented with short commentaries for the nutritional and metabolic management of patients with neoplastic diseases. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in cancer patients. Conclusion: This practical guideline gives guidance to health care providers involved in the management of cancer patients to offer optimal nutritional care.

AB - Background: This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients. Methods: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with cancer. Results: A total of 43 recommendations are presented with short commentaries for the nutritional and metabolic management of patients with neoplastic diseases. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in cancer patients. Conclusion: This practical guideline gives guidance to health care providers involved in the management of cancer patients to offer optimal nutritional care.

KW - Anorexia

KW - Cachexia

KW - Cancer

KW - Chemotherapy

KW - Malnutrition

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=85104953209&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2021.02.005

DO - 10.1016/j.clnu.2021.02.005

M3 - Article

C2 - 33946039

VL - 40

SP - 2898

EP - 2913

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 5

ER -

ESPEN practical guideline: Clinical Nutrition in cancer

Abstract

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