INTRODUCTION: Malnutrition is common in patients suffering from malignant diseases and has a major impact on patient outcomes. Prevention and early detection are crucial for effective treatment. This study aimed to investigate current international practice in the assessment and management of malnutrition in surgical oncology departments. MATERIAL AND METHODS: The survey was designed by European Society of Surgical Oncology (ESSO) and ESSO Young Surgeons and Alumni Club (EYSAC) Research Academy as an online questionnaire with 41 questions addressing three main areas: participant demographics, malnutrition assessment, and perioperative nutritional standards. The survey was distributed from October to November 2021 via emails, social media and the ESSO website to surgical networks focussing on surgical oncologists. Results were collected and analysed by an independent team. RESULTS: A total of 156 participants from 39 different countries answered the survey, reflecting a response rate of 1.4%. Surgeons reported treating a mean of 22.4 patients per month. 38% of all patients treated in surgical oncology departments were routinely screened for malnutrition. 52% of patients were perceived as being at risk for malnutrition. The most used screening tool was the "Malnutrition Universal Screening Tool" (MUST). 68% of participants agreed that the surgeon is responsible for assessing preoperative nutritional status. 49% of patients were routinely seen by dieticians. In cases of severe malnutrition, 56% considered postponing the operation. CONCLUSIONS: The reported rate of malnutrition screening by surgical oncologists is lower than expected (38%). This indicates a need for improved awareness of malnutrition in surgical oncology, and nutritional screening.

Breast Center Department of Gynaecology Rottal Inn Kliniken Eggenfelden Germany

Breast International Group Brussels Belgium

Breast Surgery Service Memorial Sloan Kettering Cancer Center New York NY USA

Department of General and Oncological Surgery Surgery C Sheba Medical Center Tel Hashomer Israel

Department of General Visceral and Transplantation Surgery University Hospital Heidelberg Germany

Department of GI Surgery and Cancer Research Institute Ghent Ghent University Hospital Belgium

Department of Medicine 1 Medical Center University of Freiburg Faculty of Medicine University of Freiburg Germany

Department of Surgery Institute of Clinical Sciences Sahlgrenska Academy Gothenburg University Sweden

Department of Surgery University Hospital Brno Faculty of Medicine Masaryk University Brno Czech Republic

Department of Surgical Oncology Institut du Cancer Montpellier University of Montpellier France

Department of Surgical Oncology Netherlands Cancer Institute Amsterdam the Netherlands

Department of Surgical Oncology Patel Hospital Karachi Pakistan

Department of Surgical Oncology Shri Guru Ram Rai Institute of Medical and Health Sciences Dehradun India

Digestive Disease Center Bispebjerg and Frederiksberg Hospitals University of Copenhagen Denmark

Division of Surgical Oncology and Thoracic Surgery Department of Surgery University Medical Center Mannheim University of Heidelberg Mannheim Germany

Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy

Medical University Pleven Pleven Bulgaria

Mount Sinai Department of Urology New York United States

Nutrition Department Champalimaud Foundation Champalimaud Centre for the Unknown Lisbon Portugal

Peter MacCallum Cancer Centre in Melbourne Australia

Surgical Oncology and Gynecologic Oncology Department Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca Romania; Breast Unit Champalimaud Clinical Centre Champalimaud Foundation Lisbon Portugal

Surgical Oncology Clinic Institute for Oncology and Radiology of Serbia Belgrade Serbia

University of Turin Torino Italy

Upper GI Unit University Hospital of Léon Spain

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