Determinants of Weight Loss and Decline in Muscle Strength in Patients with Gastrointestinal Cancer Undergoing Chemotherapy

Introduction: Gastrointestinal cancers are strongly associated with malnutrition. Additionally, chemotherapy-induced weight loss and declines in muscle strength are significantly linked to adverse clinical outcomes. Objective: To evaluate the factors associated with weight loss and decline in muscle strength in patients with gastrointestinal cancer undergoing chemotherapy. Method: This prospective observational cohort study included patients diagnosed with gastrointestinal cancer who were scheduled to undergo either neoadjuvant or exclusive chemotherapy. Assessments were conducted before and after the completion of chemotherapy. The Patient-Generated Subjective Global Assessment (PG-SGA), body weight, and handgrip strength (HGS) were measured at both time points. Results: Among the 51 patients, 53% had colorectal tumors, 53% were stage III, 76% were malnourished or suspected of being malnourished, and 84% underwent neoadjuvant chemotherapy, with a median follow-up duration of 101 days between pre-treatment consultation and consultation near the end of chemotherapy (interquartile range 58–158 days). A significant reduction in both body weight and HGS was observed in male patients; PG-SGA scores decreased significantly in both sexes. Tumor location and the interval between assessments were independently associated with weight loss. Patients with colorectal and anal canal tumors were nearly three times more likely to maintain or gain weight than those with esophageal or gastric tumors. Sex and treatment duration were significantly associated with changes in HGS. Female patients were 2.3 times more likely to maintain or improve HGS compared to males. Conclusion: This study underscores the importance of nutritional monitoring and the assessment of factors related to weight loss and muscle strength to enable the early identification of patients at nutritional risk.