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Impact of malnutrition as defined by the global leadership initiative on malnutrition criteria on the long-term prognosis in older patients with gastric cancer after gastrectomy

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Abstract

Purpose

This study investigated whether or not the impact of malnutrition, as defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria, on the long-term prognosis after gastrectomy differed between older and young patients with advanced gastric cancer.

Methods

This study included patients with primary stage I–III gastric cancer who underwent gastrectomy between April 2008 and June 2018. Patients were divided into normal, moderate, and severe malnutrition groups according to the GLIM criteria for the body mass index (BMI) and body weight loss (BWL). The primary endpoint was the overall survival (OS).

Results

Of the 512 patients, 274 (53.5%) were included in the younger group (< 70 years old) and 238 (46.5%) in the older group (≥ 70 years old). The prevalence of moderate and severe malnutrition was significantly higher in the older group than in the younger group (P < 0.001 and P = 0.001, respectively). A multivariate analysis showed that moderate malnutrition [hazard ratio (HR) 1.793, P = 0.028] and severe malnutrition (HR 2.374, P = 0.002) were independent prognostic factors in the older group but not in the younger group.

Conclusion

GLIM criteria-defined malnutrition did not correlate with the prognosis in the younger group, whereas moderate and severe malnutrition were independent poor prognostic factors for the OS in the older group.

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Funding

This research did not receive specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

    Ryota Matsui, Noriyuki Inaki & Toshikatsu Tsuji

  2. Department of Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan

    Ryota Matsui

  3. Department of Gastrointestinal Surgery/Breast Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

    Noriyuki Inaki

Authors
  1. Ryota Matsui
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  2. Noriyuki Inaki
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Contributions

RM and NI contributed equally to the conception and design of the research; RM and TT contributed to the acquisition and analysis of the data; RM and NI contributed to the interpretation of the data; and RM and NI drafted the manuscript. All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to Ryota Matsui.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study protocol was approved by the Institutional Ethical Review Committee of Ishikawa Prefectural Central Hospital (authorization number: 1875).

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Matsui, R., Inaki, N. & Tsuji, T. Impact of malnutrition as defined by the global leadership initiative on malnutrition criteria on the long-term prognosis in older patients with gastric cancer after gastrectomy. Surg Today 53, 578–587 (2023). https://doi.org/10.1007/s00595-022-02594-5

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  • DOI: https://doi.org/10.1007/s00595-022-02594-5

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