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Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy

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Abstract

Purpose

The aim of our study is firstly to evaluate the prevalence and prognostic value of nutrition risk in gastric cancer patients and secondly to explore whether the nutrition support can prolong the survival of advanced gastric cancer patients.

Methods

It contained two study periods. In the first period, we prospectively evaluated the nutritional risk of gastric adenocarcinoma patients from 2009 to 2011 using the method of European Nutritional Risk Screening (NRS) 2002. The Kaplan-Meier method and log-rank test were used to evaluate the prognostic value of high nutrition risk. The second period was between 2012 and 2013. We prospectively gave the nutrition support to stage IV gastric cancer patients whose NRS is ≥3.

Results

There were 830 patients in the first period, 50.7 % patients with a NRS ≥ 3. Patients with NRS ≥ 3 presented a significantly higher percentage of stage IV diseases, elevated values of C-reactive protein, and hypoproteinemia. The median survival was significantly higher in NRS < 3 patients (31.9 vs. 25.7 months, P < 0.001). Multivariate analysis confirmed that NRS status was an independent prognostic factor. There were 347 patients in the second period. Young, male, and good response to chemotherapy were more likely to have the NRS shift to <3 after nutrition support. The median survival was 14.3 and 9.6 months for patients with and without NRS shift, respectively, P = 0.001.

Conclusions

NRS ≥ 3 was an independent adverse prognostic factor in gastric cancer patients. For stage IV patients whose NRS ≥ 3, the nutrition support might be helpful to improve the prognosis.

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Acknowledgments

We gratefully thank the staff members in the Department of Medical Oncology and GI Surgery Oncology at Sun Yat-Sen University Cancer Center for their suggestion and assistance.

Funding

This work was supported by the third outstanding young talents training plan of Sun Yat-Sen University Cancer Center (No. 04140501#), National High Technology Research and Development Program of China (863 Program), China (No. 2012AA02A506), Natural Science Foundation of China (No. 81372570), and The Science and Technology Department of Guangdong Province, China (No. 2012B031800088).

Conflict of interest

We declare that we have no financial relationship with any organization. We have full control of all primary data and we agree to allow this journal to review our data if requested.

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Authors and Affiliations

  1. Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, China

    Miaozhen Qiu, Yi-xin Zhou, Yin Jin, Xiao-li Wei, Dong-sheng Zhang, Feng-hua Wang, Yu-hong Li & Rui-hua Xu

  2. Faculty of Medical Sciences, Sun Yat-Sen University, Guangzhou, China

    Zi-xian Wang

  3. Department of Clinical Nutrition, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Hong-yu Han & Wen-feng Ye

  4. Department of Gastric and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Zhi-wei Zhou

  5. Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China

    Da-jun Yang

  6. The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA

    Miaozhen Qiu

Authors
  1. Miaozhen Qiu
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  2. Yi-xin Zhou
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  3. Yin Jin
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  4. Zi-xian Wang
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  5. Xiao-li Wei
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  6. Hong-yu Han
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  7. Wen-feng Ye
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  8. Zhi-wei Zhou
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  9. Dong-sheng Zhang
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  10. Feng-hua Wang
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  11. Yu-hong Li
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  12. Da-jun Yang
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  13. Rui-hua Xu
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Corresponding authors

Correspondence to Da-jun Yang or Rui-hua Xu.

Additional information

Miao-zhen Qiu, Yi-xin Zhou and Ying Jin contributed equally to this manuscript.

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Qiu, M., Zhou, Yx., Jin, Y. et al. Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy. Support Care Cancer 23, 1933–1939 (2015). https://doi.org/10.1007/s00520-014-2523-6

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  • DOI: https://doi.org/10.1007/s00520-014-2523-6

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