Abstract
ObjectiveMalnutrition is recognized as a risk factor for poor outcome in patients with gastric cancer (GC). In 2018, the Global Leadership Initiative on Malnutrition (GLIM) published standardized criteria for the diagnosis of malnutrition. Our aim was to investigate whether any of the components of the GLIM diagnostic criteria were related to worse clinical outcomes in patients with GC.MethodsThis study analyzed patients with GC who underwent radical gastrectomy in our hospital between 2014 and 2019. A preoperative nutritional assessment was performed for each patient. Matching was based on the presence of three GLIM components: high weight loss (WL), low body mass index (BMI), and low skeletal muscle index (SMI).ResultsThe analysis included 1,188 patients, including 241 (20.3%) with high WL, 156 (13.1%) with low BMI, and 355 (29.9%) with low SMI. Before matching, patients who met the GLIM component criteria were mostly associated with older age, low nutritional reserves, and late tumor progression. After matching, the clinical characteristics of the three cohorts were balanced. In the matched queue, the survival prognosis of the high WL group was worse than that of the non-WL group, and the postoperative complication rate was higher in the low SMI group than in the normal SMI group (P <0.05). In addition, the clinical outcomes in the low and normal BMI groups were similar (P >0.05).ConclusionOf the GLIM criteria, high WL and low SMI may be associated with poor clinical outcomes in patients with GC, while a low BMI may not be associated with outcome.
Highlights
In 2020, the estimated number of new global cases of gastric cancer (GC) was more than one million, ranking fifth of all newly diagnosed cancers [1]
A total of 1,188 patients were included in the analysis, of which 867 (73.1%) were male
The results showed that age, low skeletal muscle index (SMI), albumin level, and Charlson score ≥2 were independent risk factors for major and severe postoperative complications (PC)
Summary
In 2020, the estimated number of new global cases of gastric cancer (GC) was more than one million, ranking fifth of all newly diagnosed cancers [1]. As a malignant tumor of the upper digestive tract, GC often aggressively impacts the nutritional status of the patient. According to the previous different definitions of malnutrition, the prevalence in GC patients ranges from 20.9% to 80.4% [2–4]. GC patients often experience tumor-related symptoms, such as cancer pain, anorexia, and malabsorption, and additional malnutrition may be induced by efforts to treat the patient, e.g., the gastrectomy itself and the side effects of adjuvant chemotherapy. 20% of cancer patients die from cachexia rather than from the malignant tumor itself [5]. Detection of malnutrition and effective nutritional interventions have been proven to have considerable clinical and financial benefits [6, 7]
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