Instruments for Evaluating the Nutritional Status of Cancer Patients Undergoing Antineoplastic Treatment: A Scoping Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This study is a scoping review of instruments utilized to assess the nutritional status of cancer patients undergoing antineoplastic treatment. The identification of widely employed nutritional assessment tools, including the PG-SGA, MNA, MUST, NRS 2002, and FAACT, alongside the acknowledgment of their subjective and objective components, provides insights into oncology nutrition. 

The authors' inclusion of the search strategy, utilized databases, and screening process enhances the transparency of the methodology, demonstrating a commendable approach to research integrity. Overall, the manuscript is well-written and effectively communicates its findings. 

However, considering the significance of sarcopenia and cancer cachexia in cancer patients undergoing treatment, it would be beneficial for the paper to address these aspects within the context of nutritional assessment. Incorporating discussions on sarcopenia and cancer cachexia would offer a more comprehensive understanding of the nutritional challenges faced by cancer patients, thereby enhancing the relevance and applicability of the paper to clinical practice.

Throughout the manuscript, there appears to be inconsistency in the abbreviation of "Quality of Life." In some instances, it is abbreviated as "QOL," while in others, the full term "Quality of Life" is used. Please correct.

Line 89- error. Oncological

Line 248- Bauer et al [ YEAR missing]

Line 316- CRP already abbreviated earlier in text

Author Response

ANSWER TO REVIEWERS

Thank you very much for the comments and time spent reading this work.

Please find below our responses to the reviewers’ comments. All the changes introduced are indicated in the document (marked in red).

“However, considering the significance of sarcopenia and cancer cachexia in cancer patients undergoing treatment, it would be beneficial for the paper to address these aspects within the context of nutritional assessment. Incorporating discussions on sarcopenia and cancer cachexia would offer a more comprehensive understanding of the nutritional challenges faced by cancer patients, thereby enhancing the relevance and applicability of the paper to clinical practice.”

The approach is a fundamental point in oncology research. The research group has taken this contribution into consideration, considering it beneficial to add it in future manuscripts. However, in this article the main objective is to find out the valid and reliable instruments in the evaluation of the nutritional status of the oncological patient. Finally, we will leave it reflected in the limitations of the study.

Translated with DeepL.com (free version)

Throughout the manuscript, there appears to be inconsistency in the abbreviation of "Quality of Life." In some instances, it is abbreviated as "QOL," while in others, the full term "Quality of Life" is used. Please correct.

You are right, we have modified it in the text.

Line 89- error. Oncological

You are right, we have modified it in the text.

Line 248- Bauer et al [ YEAR missing]

You are right, we have modified it in the text.

Line 316- CRP already abbreviated earlier in text

You are right, we have modified it in the text.

Reviewer 2 Report

Comments and Suggestions for Authors

Dear authors,

congratulations on your article. In order to contribute to the quality of your article, the following text contains suggestions for correction:

Introduction

The phrase "is of vital importance" could be simplified to "is vital."

The sentence structure in the description of HRQoL is slightly convoluted. A clearer revision could be: "HRQoL is the subjective evaluation of how health status, health care, and health promotion influence an individual's ability to function and their well-being."

The definition of cancer by WHO could be integrated more fluidly without the need for quotation marks if it is paraphrased effectively.

Methodology

This section would benefit from more specific details about the Boolean operators and DECS-MeSH descriptors used in the search strategy to allow for reproducibility.

Results

Results are well presented, understandable to the reader.

Discussion

"It can be deduced, although the authors do not suggest this, that the decision to use this version is due to the objective of the study itself, since they were more interested in weight loss and physical evaluation than in the symptoms expressed by the patient, because the intention of this cohort was protein intake as a prognostic factor during chemotherapy." This sentence is convoluted and could be broken down into two simpler sentences to enhance clarity.

Consistency in terms, such as switching between "cancer patient" and "patients with cancer," should be standardized to maintain a professional and coherent narrative.

References

The references cited throughout the introduction appear relevant and are presumably from credible sources, though it would be beneficial to ensure that all references are up to date. For instance, statements regarding the prevalence and impact of cancer in Introduction section could be strengthened by citing the latest statistics and studies.

Good luck, best regards

Author Response

ANSWER TO REVIEWERS

Thank you very much for the comments and time spent reading this work.

Please find below our responses to the reviewers’ comments. All the changes introduced are indicated in the document (marked in red).

Introduction

“The phrase "is of vital importance" could be simplified to "is vital."

You are right, we have modified it in the text.

The sentence structure in the description of HRQoL is slightly convoluted. A clearer revision could be: "HRQoL is the subjective evaluation of how health status, health care, and health promotion influence an individual's ability to function and their well-being."

You are right, we have modified it in the text.

The definition of cancer by WHO could be integrated more fluidly without the need for quotation marks if it is paraphrased effectively.”

You are right, we have modified it in the text.

Methodology

This section would benefit from more specific details about the Boolean operators and DECS-MeSH descriptors used in the search strategy to allow for reproducibility.

We have used Boolean operators and DECS-MeSH descriptors found in the search strategy table. However, I add it in the wording of the methodology.

Discussion

"It can be deduced, although the authors do not suggest this, that the decision to use this version is due to the objective of the study itself, since they were more interested in weight loss and physical evaluation than in the symptoms expressed by the patient, because the intention of this cohort was protein intake as a prognostic factor during chemotherapy." This sentence is convoluted and could be broken down into two simpler sentences to enhance clarity.

You are right, we have modified it in the text.

Consistency in terms, such as switching between "cancer patient" and "patients with cancer," should be standardized to maintain a professional and coherent narrative.

You are right, we have modified it in the text.

References

The references cited throughout the introduction appear relevant and are presumably from credible sources, though it would be beneficial to ensure that all references are up to date. For instance, statements regarding the prevalence and impact of cancer in Introduction section could be strengthened by citing the latest statistics and studies.

You are right, we have modified it in the text.

Reviewer 3 Report

Comments and Suggestions for Authors

Very interesting manuscript

well written and certainly informative

The limitations are evident 

The nutrition aspect is of importance for cancer patients but do they identify # results with # types of cancer which should have been emphasized

see attached document with additional comments

Comments for author File: Comments.pdf

Author Response

ANSWER TO REVIEWERS

Thank you very much for the comments and time spent reading this work.

Please find below our responses to the reviewers’ comments. All the changes introduced are indicated in the document (marked in red).

Why 5 years?

Regarding your first comment on the inclusion of articles from the last five years in our review, we would like to explain that this decision is based on the objective of providing an updated and relevant view of the scientific landscape regarding validated tools for measuring the nutritional status of the oncology patient. Given the rapid advancement in the field of oncology and clinical nutrition, we considered it essential to include recent research to reflect the latest trends, methodological advances, and changes in clinical practice. In addition, the selection of articles from the last five years allows us to provide our readers with a more accurate and comprehensive review of the current literature.

Why Canary Islands?

Regarding your second comment on the inclusion of incidence data specific to the Canary Islands, we would like to emphasize that we are aware of the importance of contextualizing the research in terms of the study population. Given that the authors reside in the Canary Islands, we consider it relevant to provide sociodemographic data specific to this region to enrich the understanding of the results and their applicability in our local setting. However, we understand that this information may not be generalizable to other populations, which is why we have also contextualized the international panorama.

In the introduction, results and in the discusión of the manuscript…

I have corrected the indicated spelling, wording and expressions, I have also modified the mention of the authors as you suggested. It can be seen in the text. I also added intervention in the first paragraph of the discussion, as you suggested.

What about grey literature?

The grey literature has not been included in the methodology. We will take it into account for future research, thank you very much for your comments and contribution.

Line 248- What one?

You are right, we have modified it in the text.

The nutrition aspect is of importance for cancer patients but do they identify  results with  types of cancer which should have been emphasized?

Thank you very much for your input and comments on the manuscript. You are correct, nutrition is a very important aspect in oncology patients. In relation to the types of tumor, in the introduction we have indicated those tumors with the highest incidence. On the other hand, the results do not explicitly show this difference, since the main objective of the review is: identify the valid and reliable instruments in the evaluation of the nutritional status of cancer patients with a diagnosis of solid tumor undergoing antineoplastic treatment (chemotherapy and/or immunotherapy).Even so, taking into account that solid tumors have a higher incidence of malnutrition, this has been one of the search criteria. Nevertheless, we take up the suggestion to continue with future research given the importance of the subject.

 

 

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

thanks for your review

I am happy that my comments were helpful

and

I really enjoyed reviewing it

now I know that you live in the Canarie islands