Optimizing Nutritional Care with Machine Learning: Identifying Sarcopenia Risk Through Body Composition Parameters in Cancer Patients-Insights from the NUTritional and Sarcopenia RIsk SCREENing Project (NUTRISCREEN).

Journal: Nutrients
PMID:

Abstract

: Cancer and related treatments can impair body composition (BC), increasing the risk of malnutrition and sarcopenia, poor prognosis, and Health-Related Quality of Life (HRQoL). To enhance BC parameter interpretation through Bioelectrical Impedance Analysis (BIA), we developed a predictive model based on unsupervised approaches including Principal Component Analysis (PCA) and k-means clustering for sarcopenia risk in cancer patients at the Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" (Naples). : Sarcopenia and malnutrition risks were assessed using the NRS-2002 and SARC-F questionnaires, anthropometric measurements, and BIA. HRQoL was evaluated with the EORTC QLQ-C30 questionnaire. PCA and clustering analysis were performed to identify different BC profiles. Data from 879 cancer patients (mean age: 63 ± 12.5 years) were collected: 117 patients (13%) and 128 (15%) were at risk of malnutrition and sarcopenia, respectively. PCA analysis identified three main components, and k-means determined three clusters, namely HMP (High Muscle Profile), MMP (Moderate Muscle Profile), and LMP (Low Muscle Profile). Patients in LMP were older, with a higher prevalence of comorbidities, malnutrition, and sarcopenia. In the multivariable analysis, age, lung cancer site, diabetes, and malnutrition risk were significantly associated with an increased risk of sarcopenia; among the clusters, patients in LMP had an increased risk of sarcopenia (+62%, = 0.006). : The NUTRISCREEN project, part of the ONCOCAMP study (ClinicalTrials.gov ID: NCT06270602), provides a personalized nutritional pathway for early screening of malnutrition and sarcopenia. Using an unsupervised approach, we provide distinct BC profiles and valuable insights into the factors associated with sarcopenia risk. This approach in clinical practice could help define risk categories, ensure the most appropriate nutritional strategies, and improve patient outcomes by providing data-driven care.

Authors

  • Giuseppe Porciello
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Teresa Di Lauro
    Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Assunta Luongo
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Sergio Coluccia
    Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Dipartimento di Eccellenza 2023-2027, Università degli Studi di Milano, 20133 Milan, Italy.
  • Melania Prete
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Ludovica Abbadessa
    Dietetics and Artificial Nutrition, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Elisabetta Coppola
    Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Annabella Di Martino
    Dietetics and Artificial Nutrition, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Anna Licia Mozzillo
    Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Emanuela Racca
    Experimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Arianna Piccirillo
    Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Vittoria Di Giacomo
    Dietetics and Artificial Nutrition, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Martina Fontana
    Dietetics and Artificial Nutrition, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Maria D'Amico
    Colorectal Surgical Oncology Abdominal Oncology Department, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Elvira Palumbo
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Sara Vitale
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Davide D'Errico
    Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Valeria Turrà
    Dietetics and Artificial Nutrition, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Ileana Parascandolo
    Dietetics and Artificial Nutrition, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Tiziana Stallone
    Ente Nazionale di Previdenza e Assistenza a Favore dei Biologi (ENPAB), 00153 Rome, Italy.
  • Livia S A Augustin
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Anna Crispo
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Egidio Celentano
    Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
  • Sandro Pignata
    Uroginecologic Department, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy.