Malnutrition as a Prognostic Factor in the Survival of Patients With Gastric Cancer

Abstract

AbstractObjective The purpose of this study was to identify the effects of nutritional status and sarcopenia on survival in gastric cancer (GC) patients. Research Methods: This prospective study was conducted with 150 GC patients at the oncology outpatient clinic. Malnutrition and sarcopenia status were determined according to The Patient Generated Subjective Global Assessment (PG-SGA) and anthropometric measurements. Survival analyses were conducted using Kaplan–Meier method and Cox-regression analysis. Results The mean age was 60.1 ± 11.4, and 64% (n = 96) were male, 36% were female (n = 54) patients. Severe malnutrition was observed in 63.3% (n = 95) of patients. In univariate analysis, the mean survival time (ST) for patients with a PG-SGA score < 9 point was 76.3 ± 7.4 month (95% CI:61.7–90.9), for patients with PG-SGA score ≥ 9 was 35.8 ± 4.1 month (95% CI:27.8–43.7) (p < 0.001). The mean ST for patients with and without sarcopenia was 32.0 ± 7.3 month (95% CI:17.7–46.3), 54.1 ± 4.8 month (95% CI:44.7–63.6) respectively (p < 0.05). In multivariate analysis, the risk of death in the patients who didn’t undergo gastrectomy [HR = 1.9 (95% CI:1.2–2.9)], malnourished [HR = 2.3 (95% CI:1.5–3.5)], had metastases [HR = 2.4 (95% Cl:1.4-4.0)] was higher. With the adjustment there was no association between the survival and sarcopenia (p > 0,05). Conclusions Malnutrition was identified as one of the independent risk factors for survival in GC patients, similar to the presence of metastases and the absence of gastrectomy. GC patients should be followed carefully in terms of these issues and nutritional interventions should be made when necessary.