Association of patient-generated subjective global assessment (PG-SGA) scores with survival outcomes in cancer patients: A systematic review and meta-analysis.

[BACKGROUND AND OBJECTIVES] Undernutrition is prevalent among patients with cancer and may be associated with survival. The Patient-Generated Subjective Global Assessment (PG-SGA) is a widely recognised scale for the nutritional assessment of patients with cancer. The relationship between undernutrition, as defined by the PG-SGA, and cancer prognosis has been somewhat controversial, and this meta-analysis sought to clarify this. This meta-analysis was performed to elucidate the association between undernutrition, as defined by the PG-SGA, and survival outcomes in patients with cancer.

[METHODS AND STUDY DESIGN] Studies that investigated the association between undernutrition, defined by the PG-SGA, and survival outcomes in patients with cancer were included, and data were retrieved from PubMed, EMBASE, the Cochrane Library, and Web of Science until October 2023.

[RESULTS] A total of 18 prospective and 14 retrospective studies with 27120 cancer patients were identified in this analysis. All studies had high methodological quality, with an average score of 7.66. The results showed that undernutrition, as defined by the PG-SGA, was significantly correlated with worse overall survival (Hazard Ratio (HR) = 1.99, 95% Confidence Interval (CI): 1.62-2.45). Subgroup analyses further confirmed that the pooled HR was 1.64 (95% CI: 1.26-2.13) for moderate undernutrition, which increased gradually in cases of severe undernutrition (HR = 2.65, 95% CI: 2.45-2.87). The degree of undernutrition might be the source of the heterogeneity (p value for the test of subgroup differences was < 0.001). Sensitivity analyses confirmed the robustness and credibility of this meta-analysis.

[CONCLUSIONS] These results under-score the significant association between undernutrition, as defined by the PG-SGA, and reduced overall survival in patients with cancer. Detection of nutritional status using the PG-SGA may be beneficial for improving survival in patients with cancer.