Background The survival impact of the geriatric nutrition risk index (GNRI) has yet to be investigated in patients undergoing gastric carcinoma (GC) surgery. Methods In total, 1166 GC patients who underwent radical gastrectomy were retrospectively reviewed. The predictive and discrimination abilities for overall survival (OS) were compared among GNRI, nutrition indices, and systemic inflammatory markers. Patients were dichotomized by GNRI (GNRI <98, low; GNRI ≥98, high), and the impacts of GNRI on OS and cancer‐specific survival (CSS) were evaluated using Cox hazards analysis. Results GNRI showed superior discrimination and predictive ability for OS as compared with other indices. There were 447 (38.3%) and 719 (61.7%) patients in the low‐ and high‐GNRI groups, respectively. Patients with low GNRI were older and had a higher pStage III disease rate than those with high GNRI (P < .001). OS curves were significantly stratified by GNRI in all patients (P < .001) and those with pStage I (P < .001), II (P < .001), and III (P = .02) disease. Multivariate analysis showed low GNRI to be independently associated with poor OS (hazard ratio [HR], 2.15; 95% CI, 1.612.87; P < .001). Furthermore, low GNRI was an independent predictor of poor CSS (HR, 1.61; 95% CI, 1.072.44; P = .02), as were total gastrectomy (P < .001) and pStage III disease (P < .001). Patients who had low GNRI and underwent total gastrectomy showed quite poor 5‐year OS (54.8%). Conclusion GNRI is useful for predicting survival and oncological outcomes in GC patients.

Advanced gastric cancer, especially scirrhous gastric cancer with peritoneal dissemination, remains refractory to conventional therapies. G47D, a third-generation oncolytic herpes simplex virus type 1, is an attractive novel therapeutic agent for solid cancer. In this study, we investigated the therapeutic potential of G47D for human gastric cancer. In vitro, G47D showed good cytopathic effects and replication capabilities in nine human gastric cancer cell lines tested. In vivo, intratumoral inoculations with G47D (2 Â 10 5 or 1 Â 10 6 plaqueforming units [PFU]) significantly inhibited the growth of subcutaneous tumors (MKN45, MKN74, and 44As3). To evaluate the efficacy of G47D for advanced-stage models of gastric cancer, we generated an orthotopic tumor model and peritoneal dissemination models of human scirrhous gastric cancer (MKN45-luc and 44As3Luc), which have features mimicking intractable scirrhous cancer patients. G47D (1 Â 10 6 PFU) was constantly efficacious whether administered intratumorally or intraperitoneally in the clinically relevant models. Notably, G47D injected intraperitoneally readily distributed to, and selectively replicated in, disseminated tumors. Furthermore, flow cytometric analyses of tumor-infiltrating cells in subcutaneous tumors revealed that intratumoral G47D injections markedly decreased M2 macrophages while increasing M1 macrophages and natural killer (NK) cells. These findings indicate the usefulness of G47D for treating human gastric cancer, including scirrhous gastric cancer and the ones in advanced stages.

Colorectal surgery, open abdominal surgery, and smoking history were found to be independent predictive factors for PPOI in patients who underwent major abdominal surgery. A nomogram based on these factors was shown to be useful for identifying patients with a high probability of developing PPOI.

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