Gender-based differences in malnutrition among patients with stage IV lung adenocarcinoma.

Abstract

e22669 Background: Malnutrition, cachexia and weight loss are potential complications in patients with advanced lung cancer and are associated with worse clinical outcomes. Data evaluating sex-based differences in malnutrition among patients with metastatic lung adenocarcinoma remain limited. Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, that includes 172 healthcare organizations in the United States of America. Adults with age 18–90 years with Stage IV lung adenocarcinoma were identified. Cohort A included females (n=1,075) and Cohort B included males (n=1,128). Malnutrition was defined by ICD-10 codes for malnutrition (E40–E46), cachexia (R64), or abnormal weight loss (R63.4) occurring within 365 days of diagnosis. Patients with malnutrition prior to the index event were excluded. Propensity score matching (1:1) was performed for age, race/ethnicity, and comorbidities that included nicotine dependence, heart failure, diabetes mellitus, overweight/obesity, disorders of the thyroid gland, alcohol use disorder and nicotine use disorder. Risk-based outcomes were compared between cohorts. Results: After propensity score matching, 877 patients remained in each cohort. Within one year of diagnosis, malnutrition occurred in 8.1% of females (67/832) and 11.6% of males (94/812). Female sex was associated with a significantly lower risk of malnutrition compared with males (risk difference −3.5%, 95% CI −6.4 to −0.6; p=0.016). The risk ratio was 0.70 (95% CI 0.52–0.94), and the odds ratio was 0.67 (95% CI 0.48–0.93). Conclusions: In this multicenter cohort of patients with Stage IV lung adenocarcinoma, males experienced a significantly higher risk of malnutrition within one year of diagnosis compared with females. These findings support the need for careful nutritional screening and targeted interventions, particularly among male patients with advanced lung cancer.