{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:45:52Z","timestamp":1790790352867,"version":"4.1.0"},"reference-count":79,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Abbott"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Nutritional issues, including malnutrition, low muscle mass, sarcopenia (i.e., low muscle mass and strength), and cachexia (i.e., weight loss characterized by a continuous decline in skeletal muscle mass, with or without fat loss), are commonly experienced by patients with cancer at all stages of disease. Cancer cachexia may be associated with poor nutritional status and can compromise a patient\u2019s ability to tolerate antineoplastic therapy, increase the likelihood of post-surgical complications, and impact long-term outcomes including survival, quality of life, and function. One of the primary nutritional problems these patients experience is malnutrition, of which muscle depletion represents a clinically relevant feature. There have been recent calls for nutritional screening, assessment, treatment, and monitoring as a consistent component of care for all patients diagnosed with cancer. To achieve this, there is a need for a standardized approach to enable oncologists to identify patients commencing and undergoing antineoplastic therapy who are or who may be at risk of malnutrition and\/or muscle depletion. This approach should not replace existing tools used in the dietitian\u2019s role, but rather give the oncologist a simple nutritional protocol for optimization of the patient care pathway where this is needed. Given the considerable time constraints in day-to-day oncology practice, any such approach must be simple and quick to implement so that oncologists can flag individual patients for further evaluation and follow-up with appropriate members of the multidisciplinary care team. To enable the rapid and routine identification of patients with or at risk of malnutrition and\/or muscle depletion, an expert panel of nutrition specialists and practicing oncologists developed the PROtocol for NuTritional risk in Oncology (PRONTO). The protocol enables the rapid identification of patients with or at risk of malnutrition and\/or muscle depletion and provides guidance on next steps. The protocol is adaptable to multiple settings and countries, which makes implementation feasible by oncologists and may optimize patient outcomes. We advise the use of this protocol in countries\/clinical scenarios where a specialized approach to nutrition assessment and care is not available.<\/jats:p>","DOI":"10.3390\/cancers15020380","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T04:47:08Z","timestamp":1673239628000},"page":"380","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Oncology-Led Early Identification of Nutritional Risk: A Pragmatic, Evidence-Based Protocol (PRONTO)"],"prefix":"10.3390","volume":"15","author":[{"given":"Maurizio","family":"Muscaritoli","sequence":"first","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Bar-Sela","sequence":"additional","affiliation":[{"name":"Oncology Department, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1063-1717","authenticated-orcid":false,"given":"Nicolo Matteo Luca","family":"Battisti","sequence":"additional","affiliation":[{"name":"The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK"},{"name":"Breast Cancer Research Division, The Institute of Cancer Research, London SW3 6JJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borislav","family":"Belev","sequence":"additional","affiliation":[{"name":"Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Contreras-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital Regional de Malaga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Cortesi","sequence":"additional","affiliation":[{"name":"Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ione","family":"de Brito-Ashurst","sequence":"additional","affiliation":[{"name":"The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Prado","sequence":"additional","affiliation":[{"name":"Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Ravasco","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Centre for Interdisciplinary Research in Health (CIIS-UCP), Universidade Cat\u00f3lica Portuguesa, 1649-023 Lisbon, Portugal"},{"name":"Centre for Interdisciplinary Research Egas Moniz (CiiEM), Instituto Universit\u00e1rio Egas Moniz, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suayib","family":"Yalcin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Institute of Cancer, Hacettepe University, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1038\/s41430-018-0245-4","article-title":"Cancer-associated malnutrition","volume":"72","author":"Baracos","year":"2018","journal-title":"Eur. 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