Prognostic value of the Global Leadership Initiative on Malnutrition for clinical outcomes in outpatients with colorectal and/or lung cancer: an observational prospective study.

OBJECTIVES

The Global Leadership Initiative on Malnutrition (GLIM) was established to standardize malnutrition diagnosis. Despite growing research, few studies have investigated its application in outpatients. This study assessed the prognostic value of GLIM combinations in colorectal and/or lung cancer outpatients.

METHODS

Ninety-two outpatients with colorectal and/or lung cancer at different treatment stages were assessed between December 2022 and July 2024. Nutritional status was classified using eight GLIM combinations. Phenotypic criteria (weight loss, reduced muscle mass, reduced muscle strength) remained constant across all models, while etiologic criteria (reduced intake, inflammation, cancer-related burden) varied. Classifications were compared with the Subjective Global Assessment. The prognostic value was evaluated for 12-mo mortality. Logistic regression, Kaplan-Meier analysis, and Cox regression were adjusted for age, sex, cancer stage, tumor site, and Eastern Cooperative Oncology Group status.

RESULTS

The mean patient age was 64 y (interquartile range: 57-74 y). Malnutrition prevalence ranged from 30.4% to 89.1% depending on the GLIM combinations. When reduced intake was combined with any phenotypic criteria, 12-mo mortality risk increased 5.6-19.8-fold. The combination including all phenotypic and etiologic variables independently predicted shorter survival.

CONCLUSIONS

Malnutrition prevalence and prognostic performance varied according to the GLIM combination, influencing predictive accuracy for mortality. As evidence grows regarding which models achieve the greatest diagnostic accuracy in oncology, combinations including phenotypic criteria and reduced intake should be prioritized to optimize prognostic evaluation and clinical decision-making.