Prevalence and Prognostic Significance of Malnutrition in Patients with Brain Metastasis

Background: Malnutrition is a severe but modifiable risk factor for cancers. However, the relationship between malnutri-tion and the survival of patients with brain metastases has not been fully revealed. We aimed to evaluate the prevalence of malnutrition and assess its prognostic value on patients with brain metastases Methods: We retrospectively recruited 2,633 patients with brain metastases between January 2014 and September 2020. Three malnutrition scores were used to evaluate patients' malnutrition status at their first admission, including con-trolling nutritional status, the nutritional risk index, and the prognostic nutritional index. The association between mal-nutrition and overall survival (OS) was estimated. Results: The three malnutrition scores were associated with each other and with body mass index (BMI). Malnutrition assessed by any of the three scores was significantly associated with poor OS. All three malnutrition scores were better indicators than BMI, and adding mal-nutrition scores to the Graded Prognostic Assessment (GPA) scoring system could significantly improve the accuracy of prognosis prediction. Conclusions: Malnutrition monitoring using any of the three malnutrition scores on patients' first admission could be a better survival indicator for patients with brain metastases compared with BMI alone. Impact: Malnutrition is a more significant indicator of sur-vival stratification compared with BMI. Adding malnutrition to the GPA score system achieves better survival prediction.