{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:02:03Z","timestamp":1792008123531,"version":"4.4.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Greifswald's publication fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a high malnutrition risk in patients with gastrointestinal tumors. Yet it is unknown when malnutrition manifests and how changes in nutritional status are related to quality of life and fatigue at different stages of oncologic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In a prospective observational study, we recruited patients with initial diagnosis of any gastrointestinal tumor requiring systemic therapy and respective patients already receiving treatment. Subjects underwent comprehensive nutritional assessment at enrollment and after 3\u2009months. In addition, patients reported data on physical activity (IPAQ-SF), quality of life (SF-12), and fatigue (EORTC QLQ-FA12). Besides baseline associations, relations between changes in nutritional status and patient-reported outcomes during treatment were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 66 patients (mean(\u00b1SD) age: 62.1(\u00b110.6) yrs.; 68% male), of which 29 had received initial diagnosis and 37 were already undergoing treatment. Baseline clinical characteristics and nutritional status were comparable between groups. With 88% of patients, GLIM-defined malnutrition was highly prevalent at baseline and associated with fatigue, reduced physical activity, and quality of life (P\u2009&amp;lt;\u2009.01, respectively). Among 36 study completers, only minor fat mass (P\u2009=\u2009.033) and progressed weight loss (P\u2009=\u2009.025) indicated further nutritional deterioration. Development of cachexia, but not malnutrition or sarcopenia, during treatment was associated with impaired patient-reported outcomes, ie, higher fatigue (rho\u2009=\u20090.400; P\u2009=\u2009.019) and lowered physical activity (rho=-0.423; P\u2009=\u2009.013).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most patients with gastrointestinal cancer are malnourished already at diagnosis. Impaired nutritional status is closely linked with reduced quality of life and fatigue, especially their physical components. Trials are warranted to test whether optimized nutrition support can halt further aggravation during treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag028","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T12:42:25Z","timestamp":1769863345000},"source":"Crossref","is-referenced-by-count":3,"title":["Malnutrition in gastrointestinal cancer manifests before systemic therapy and is associated with fatigue and reduced physical quality of life"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2338-2174","authenticated-orcid":false,"given":"Mats L","family":"Wiese","sequence":"first","affiliation":[{"name":"Department of Food Nutrition Facilities, University of Applied Sciences M\u00fcnster , M\u00fcnster,","place":["Germany"]},{"name":"Department of Medicine A, University Medicine Greifswald , Greifswald,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Schwarz","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich, University of Zurich , Zurich,","place":["Switzerland"]},{"name":"Institute of Evidence-based Dietetics (NIED), University of Applied Sciences Neubrandenburg , Neubrandenburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"von Rheinbaben","sequence":"additional","affiliation":[{"name":"Department of Medicine C, University Medicine Greifswald , Greifswald,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Medicine A, University Medicine Greifswald , Greifswald,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Blaurock","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Greifswald , Greifswald,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kr\u00f6nke","sequence":"additional","affiliation":[{"name":"Department of Medicine C, University Medicine Greifswald , Greifswald,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus M","family":"Lerch","sequence":"additional","affiliation":[{"name":"University Hospital, Ludwig Maximilians University Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luzia","family":"Valentini","sequence":"additional","affiliation":[{"name":"Institute of Evidence-based Dietetics (NIED), University of Applied Sciences Neubrandenburg , Neubrandenburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0569-7316","authenticated-orcid":false,"given":"Ali A","family":"Aghdassi","sequence":"additional","affiliation":[{"name":"Department of Medicine A, University Medicine Greifswald , Greifswald,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"2026031408070574000_oyag028-B1","doi-asserted-by":"crossref","first-page":"3283","DOI":"10.3390\/nu15143283","article-title":"The prevalence and impact of nutritional risk and malnutrition in gastrointestinal surgical oncology patients: a prospective, observational, multicenter, and exploratory study","volume":"15","author":"Dur\u00e1n Poveda","year":"2023","journal-title":"Nutrients"},{"key":"2026031408070574000_oyag028-B2","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.clnu.2018.04.007","article-title":"Prevalence of malnutrition and impact on clinical outcomes in cancer services: a comparison of two time points","volume":"38","author":"Marshall","year":"2019","journal-title":"Clin Nutr. 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