Poor nutritional status and sarcopenia influences survival outcomes in gastric carcinoma patients undergoing radical surgery

Sugawara, Katsuhiko; Yamashita, Hiroharu; Urabe, Masayuki; Okumura, Yasuhiro; Yagi, Koichi; Aikou, Susumu; Seto, Yasuyuki

doi:10.1016/j.ejso.2020.04.044

Cited by 20 publications

(17 citation statements)

References 39 publications

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“…We used the cut‐off value utilized in our previous prospective research (<40.8 cm 2 /m 2 for men and <34.9 cm 2 /m 2 for women) 19,20 . The cut‐off values are close to those used in studies of patients with GC from other Asian countries (<43.8 cm 2 /m 2 for men and <35.3 cm 2 /m 2 for women) 32 . Because the body sizes and BMI of Westerners and Easterners are quite different, the SMI cut‐off values used for both groups are also different (<52.4 cm 2 /m 2 for men and <38.5 cm 2 /m 2 for women) 18 …”

Section: Discussionmentioning

confidence: 99%

Impact of malnutrition diagnosed using Global Leadership Initiative on Malnutrition criteria on clinical outcomes of patients with gastric cancer

Shi

Huang

et al. 2021

J Parenter Enteral Nutr

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Objective: Our objective is to validate the effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria in malnutrition diagnosis compared with Patient-Generated Subjective Global Assessment (PG-SGA) and assess the impact of malnutrition diagnosed using GLIM criteria on the clinical outcomes of patients with GC. Methods:We retrospectively analyzed the data of 895 patients who underwent radical gastrectomy at the First Affiliated Hospital of Wenzhou Medical University. Nutrition assessment was performed on all patients according to the GLIM criteria and PG-SGA.The κ statistic was used to evaluate the agreement between two methods. Multivariate logistic regression and Cox regression based on single-factor analysis were used to predict postoperative complications and overall survival rates.Results: Based on the GLIM criteria, 38.3% of the patients were diagnosed as malnourished, including 21.7% Stage I (moderate malnutrition) and 16.6% Stage II (severe malnutrition). GLIM criteria had a moderate agreement with PG-SGA (κ = 0.548).Patients in the Stage II malnutrition group had a higher incidence of complications, a longer postoperative length of stay, and higher hospitalization costs. Logistic regression showed that Stage II malnutrition was an independent risk predictor of postoperative complications (odds ratio, 3.28; 95% confidence interval [CI], 2.18-4.94). Furthermore, Cox regression analysis showed that both Stage I (hazard ratio [HR], 1.52; 95% CI, 1.11-2.07; P = .009) and Stage II (HR, 1.85; 95% CI, 1.34-2.53; P < .001) malnutrition were independent risk predictors of overall survival. Conclusion:Diagnosis of malnutrition according to the GLIM criteria is useful in predicting the adverse postoperative clinical outcomes of patients with gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Impact of malnutrition diagnosed using Global Leadership Initiative on Malnutrition criteria on clinical outcomes of patients with gastric cancer

Shi

Huang

et al. 2021

J Parenter Enteral Nutr

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“…Malnutrition is associated with a decline in general functional status, delayed post-surgery recovery, high hospitalization, and increased mortality [ 26 ]. Serum albumin represents the nutritional and inflammatory status of the human body [ 27 , 28 ]. Cancer-related malnutrition is a multimodal process, because many factors collude with each other; impair food intake; increase energy and protein requirements; reduce synthetic stimuli, such as physical activity; and change the metabolism of different organs or tissues.…”

Section: Discussionmentioning

confidence: 99%

A novel nutrition-related nomogram for the survival prediction of colorectal cancer-results from a multicenter study

et al. 2023

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Background Precisely predicting the short- and long-term survival of patients with cancer is important. The tumor-node-metastasis (TNM) stage can accurately predict the long-term, but not short-term, survival of cancer. Nutritional status can affect the individual status and short-term outcomes of patients with cancer. Our hypothesis was that incorporating TNM stage and nutrition-related factors into one nomogram improves the survival prediction for patients with colorectal cancer (CRC). Method This multicenter prospective primary cohort included 1373 patients with CRC, and the internal validation cohort enrolled 409 patients with CRC. Least absolute shrinkage and selection operator regression analyses were used to select prognostic indicators and develop a nomogram. The concordance (C)-index, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to assess the prognostic discriminative ability of the nomogram, TNM stage, Patient-Generated Subjective Global Assessment (PGSGA), and TNM stage + PGSGA models. The overall survival (OS) curve of risk group stratification was calculated based on the nomogram risk score. Results TNM stage, radical resection, reduced food intake, activities and function declined, and albumin were selected to develop the nomogram. The C-index and calibration plots of the nomogram showed good discrimination and consistency for CRC. Additionally, the ROC curves and DCA of the nomogram showed better survival prediction abilities in CRC than the other models. The stratification curves of the different risk groups of the different TNM categories were significantly different. Conclusion The novel nomogram showed good short- and long-term outcomes of OS in patients with CRC. This model provides a personalized and convenient prognostic prediction tool for clinical applications.

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“…Insufficient energy and protein intake were independent risk factors for skeletal sarcopenia (42). A poor nutritional status can lead to immune dysfunction and muscle atrophy (45). Systemic inflammation is related to anorexia and insufficient nutrient intake, which in turn lead to accelerated loss of skeletal muscle.…”

Section: Discussionmentioning

confidence: 99%

Association Between Systemic Inflammation and Malnutrition With Survival in Patients With Cancer Sarcopenia—A Prospective Multicenter Study

Ruan

Xie

et al. 2022

Front. Nutr.

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ObjectiveSystemic inflammation and malnutrition are correlated with cancer sarcopenia and have deleterious effects on oncological outcomes. However, the combined effect of inflammation and malnutrition in patients with cancer sarcopenia remains unclear.MethodsWe prospectively collected information on 1,204 patients diagnosed with cancer sarcopenia. the mean (SD) age was 64.5 (11.4%) years, and 705 (58.60%) of the patients were male. The patients were categorized into the high advanced lung cancer inflammation index (ALI) group (≥18.39) and the low ALI group (<18.39) according to the optimal survival cut-off curve. We selected the optimal inflammation marker using the C-index, decision curve analysis (DCA), and a prognostic receiver operating characteristic curve. Univariate and multivariate survival analyses were performed to determine the prognostic value of the optimal inflammation indicator. We also analyzed the association between inflammation and malnutrition in patients with cancer.ResultsThe C-index, DCA, and prognostic area under the curve of ALI in patients with cancer sarcopenia were higher or better than those of neutrophil-lymphocyte ratio (NLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and platelet-lymphocyte ratio (PLR). The prognosis for patients in the low ALI group was worse than that of patients in the high ALI group [HR (95%CI) = 1.584 (1.280–1.959), P < 0.001]. When the ALI was divided into quartiles, we observed that decreased ALI scores strongly correlated with decreased overall survival (OS). Patients with both a low ALI and severe malnutrition (vs. patients with high ALI and well-nourished) had a 2.262-fold death risk (P < 0.001). Subgroup analysis showed a significant interactive association between the ALI and death risk in terms of TNM stage (P for interaction = 0.030).ConclusionsThe inflammation indicator of the ALI was better than those of the NLR, PNI, SII, and PLR in patients with cancer sarcopenia. Inflammation combined with severe malnutrition has a nearly 3-fold death risk in patients with cancer sarcopenia, suggesting that reducing systemic inflammation, strengthening nutritional intervention, and improving skeletal muscle mass are necessary.

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Poor nutritional status and sarcopenia influences survival outcomes in gastric carcinoma patients undergoing radical surgery

Cited by 20 publications

References 39 publications

Impact of malnutrition diagnosed using Global Leadership Initiative on Malnutrition criteria on clinical outcomes of patients with gastric cancer

Impact of malnutrition diagnosed using Global Leadership Initiative on Malnutrition criteria on clinical outcomes of patients with gastric cancer

A novel nutrition-related nomogram for the survival prediction of colorectal cancer-results from a multicenter study

Association Between Systemic Inflammation and Malnutrition With Survival in Patients With Cancer Sarcopenia—A Prospective Multicenter Study

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