{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:03:29Z","timestamp":1792598609795,"version":"4.5.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malnutrition is prevalent in colorectal cancer (CRC) and may adversely influence oncologic prognosis and perioperative recovery. This systematic review and meta-analysis quantified associations between malnutrition diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria and clinical outcomes in CRC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Embase, Web of Science Core Collection, and The Cochrane Library were searched through December 31, 2025. Observational cohort studies enrolling adults with CRC and reporting outcomes according to GLIM-defined malnutrition were included. Study quality was assessed using the Newcastle\u2013Ottawa Scale. Pooled hazard ratios (HRs), risk ratios (RRs), and mean differences (MDs) with 95% confidence intervals (CIs) were synthesized using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine cohort studies involving 4,771 patients were included. GLIM-defined malnutrition was associated with poorer overall survival (HR 1.23, 95% CI 1.12\u20131.33; I\u00b2 = 56.4%). It was also associated with increased postoperative infectious complications (RR 1.61, 95% CI 1.51\u20131.98; I\u00b2 = 0.0%), major complications (RR 1.36, 95% CI 1.18\u20131.60), overall postoperative complications (RR 1.44, 95% CI 1.25\u20131.56), 30-day mortality (RR 2.03, 95% CI 1.35\u20133.31), and 30-day readmission (RR 1.34, 95% CI 1.01\u20131.64). Malnutrition was further associated with prolonged length of hospital stay (MD 2.30 days, 95% CI 1.40\u20133.10). Sensitivity and subgroup analyses supported the robustness of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GLIM-defined malnutrition is associated with inferior survival, increased postoperative morbidity, and greater healthcare utilization in CRC. These findings support routine nutritional screening followed by GLIM-based assessment for perioperative risk stratification and clinical management in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD420261324729.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1789366","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:44:25Z","timestamp":1778215465000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between malnutrition and prognosis in colorectal cancer: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Chao","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Xiongan Xuanwu Hospital, Xiongan New Area","place":["Baoding, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu-Ning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Digestive Endoscopy, Hebei Provincial Hospital of Traditional Chinese Medicine","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)00001-5","article-title":"Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries","volume":"397","year":"2021","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(22)00168-1","article-title":"Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study","volume":"10","year":"2022","journal-title":"Lancet Glob Health"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.766398","article-title":"Association of systemic inflammation and malnutrition with survival in nasopharyngeal carcinoma undergoing chemoradiotherapy: results from a multicenter cohort study","volume":"11","author":"Wang","year":"2021","journal-title":"Front Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(22)00550-2","article-title":"Impact of malnutrition on early outcomes after cancer surgery: an international, multicentre, prospective cohort study","volume":"11","year":"2023","journal-title":"Lancet Glob Health"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2147\/rmhp.S496098","article-title":"Epidemiology, controversies, and dilemmas of perioperative nutritional risk\/malnutrition: a narrative literature review","volume":"18","author":"He","year":"2025","journal-title":"Risk Manag Healthc Policy"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.3390\/antiox14111289","article-title":"Cancer-related malnutrition and oxidative stress in colorectal cancer surgery: a narrative review of pathophysiology and postoperative outcomes","volume":"14","author":"Zahorodnii","year":"2025","journal-title":"Antioxidants (Basel)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/s0261-5614(02)00214-5","article-title":"Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials","volume":"22","author":"Kondrup","year":"2003","journal-title":"Clin Nutr"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/0899-9007(96)90011-8","article-title":"Definition of standardized nutritional assessment and interventional pathways in oncology","volume":"12","author":"Ottery","year":"1996","journal-title":"Nutrition"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.7603\/s40681-015-0017-6","article-title":"The malnutrition universal screening tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients","volume":"5","author":"Chao","year":"2015","journal-title":"Biomedicine (Taipei)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clnu.2018.08.002","article-title":"GLIM criteria for the diagnosis of malnutrition - 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