Assessment of registered dietitians’ ability to estimate resting and total energy expenditure in hepatocellular carcinoma patients

Hepatocellular carcinoma (HCC) is a highly fatal cancer that is increasing in prevalence worldwide. Treatment for HCC typically involves a combination of surgery and pharmacotherapy that often results in inadequate oral intake, malnutrition, and weight loss. Nutrition status plays a critical role in chemotherapy tolerance and overall morbidity and mortality of HCC, but there is a paucity of research documenting how Registered Dietitians (RDs) typically determine energy needs of HCC patients. The purpose of this was to assess if RDs could accurately estimate the energy needs of the HCC patients presented in two case studies. The study also assessed the factors that led to more accurate energy estimation. Overall, RDs overestimated both patients’ needs by >10% and there was high variability in their responses. There was no single factor that led RDs to better estimation, indicating the need for better evidence-based resources to recommend predictive equations or estimation tools for this unique population.