Association between Risk of Malnutrition Defined by the Nutritional Risk Screening 2002 and Postoperative Complications and Overall Survival in Patients with Cancer: A Meta-Analysis

The Nutritional Risk Screening 2002 (NRS 2002) has been applied as a nutritional screening tool in oncology patients. This meta-analysis aimed to assess the association between the risk of malnutrition defined by the NRS 2002 and adverse outcomes in patients with cancer. We comprehensively searched PubMed, Embase, and Web of Science until May 7, 2023. Studies investigating the association between the risk of malnutrition defined by the NRS 2002 and overall survival or postoperative complications in adult patients with cancer were included. Patients were grouped as being at risk of malnutrition (NRS2002 ≥ 3) and not at risk (NRS 2002 < 3). Twenty-two studies involving 9,332 patients were identified. The reported prevalence of the risk of malnutrition ranged from 12.8% to 80.8%. Meta-analysis indicated that cancer patients with a risk of malnutrition had a poor overall survival (hazard ratio 1.66; 95% confidence intervals [CI] 1.40-1.97). Furthermore, the pooled adjusted odds ratio of postoperative complications was 2.27 (95% CI 1.81-2.84) for the risk of malnutrition. The risk of malnutrition defined by the NRS 2002 is independently associated with an increased risk of postoperative complications and worse overall survival in patients with cancer. NRS 2002 can serve as a promising risk stratification tool in cancer patients.