The predictive ability of the modified frailty index (mFI) for postoperative outcomes and survival in patients with gastric cancer (GC) remains uncertain.

Studies were retrieved from 11 electronic databases. Odds ratio (OR) and 95% confidence intervals (CIs) were used to report surgical outcomes, including overall survival (OS), complications, mortality, readmission, and nonhome discharge. The fixed or random effects model was used depending on the heterogeneity. Subgroup and meta-regression analyses were performed to determine the source of heterogeneity.

This meta-analysis of 13 studies, including 15 359 GC patients, showed that high mFI scores were associated with reduced OS (OR = 1.35) and increased risk of poor postoperative outcomes (OR = 2.61). The older patients with higher mFI scores had a higher risk of worse OS after gastrectomy (OR = 1.69).

This study demonstrated that high mFI scores were strongly associated with reduced OS and increased risk of poor outcomes following surgery in patients with GC, with a more than two-fold increase in the overall risk of poor outcomes. Compared to other tools, the mFI is easy to operate, making it an effective tool for prognosis assessment and personalized treatment and care planning.

PROSPERO (Registration Number: CRD42024613727).

This study aimed to develop an intelligent individualized nutrition management (iNutrition) applet for postdischarge gastric cancer patients following gastrectomy based on the Health Action Process Approach (HAPA) theory and using the design thinking method.

We developed the iNutrition applet using the design thinking method, including the following phases: (1) "empathize and define," which focused on understanding patients' needs and establishing the goals of the iNutrition applet through qualitative interviews; (2) "ideate and prototype," during which literature reviews and multidisciplinary interactive workshops to conceptualize innovative solutions were conducted and a fully functional iNutrition applet was developed; and (3) "test," during which the iNutrition applet was evaluated through usability testing.

Based on qualitative interviews with 15 patients, we determined that the iNutrition applet would need to satisfy patients' needs in the following areas: adjustment to postoperative anatomical changes, evidence-based knowledge, communication with peers, consultation with medical staff, tailored nutritional plans, coping plans, and needs for technology. Consequently, the applet was designed to have eight functions: gastrointestinal symptom management, nutrition knowledge, medical consultation, peer communication, nutrition goals, nutrition diary with calculator, weekly meal plan, and nutritional status score. During short-term usability testing, the patients' task completion rate ranged from 88 to 100%. Long-term usability testing resulted in a System Usability Scale (SUS) score of 75.20 ± 10.63 and a net promoter score (NPS) of 32%. The participants were generally satisfied with the applet's design and functionality, providing feedback that informed further refinements to the final version of the applet.

The iNutrition applet, which has received high ratings for usability and user satisfaction, is an acceptable and feasible method of postdischarge nutritional management for gastric cancer patients following gastrectomy.

The objective is to systematically gather relevant research to determine and quantify the risk factors and pooled prevalence for pneumonia after a radical gastrectomy for gastric cancer.

The reporting procedures of this meta-analysis conformed to the PRISMA 2020. Chinese Wan Fang data, Chinese National Knowledge Infrastructure (CNKI), Chinese Periodical Full-text Database (VIP), Embase, Scopus, CINAHL, Ovid MEDLINE, PubMed, Web of Science, and Cochrane Library from inception to January 20, 2024, were systematically searched for cohort or case-control studies that reported particular risk factors for pneumonia after radical gastrectomy for gastric cancer. The pooled prevalence of pneumonia was estimated alongside risk factor analysis. The quality was assessed using the Newcastle-Ottawa Scale after the chosen studies had been screened and the data retrieved. RevMan 5.4 and R 4.4.2 were the program used to perform the meta-analysis.

Our study included data from 20,840 individuals across 27 trials. The pooled prevalence of postoperative pneumonia was 11.0% (95% CI = 8.0% ~ 15.0%). Fifteen risk factors were statistically significant, according to pooled analyses. Several factors were identified to be strong risk factors, including smoking history (OR 2.71, 95% CI = 2.09 ~ 3.50, I2 = 26%), prolonged postoperative nasogastric tube retention (OR 2.25, 95% CI = 1.36-3.72, I2 = 63%), intraoperative bleeding ≥ 200 ml (OR 2.21, 95% CI = 1.15-4.24, I2 = 79%), diabetes mellitus (OR 4.58, 95% CI = 1.84-11.38, I2 = 96%), male gender (OR 3.56, 95% CI = 1.50-8.42, I2 = 0%), total gastrectomy (OR 2.59, 95% CI = 1.83-3.66, I2 = 0%), COPD (OR 4.72, 95% CI = 3.80-5.86, I2 = 0%), impaired respiratory function (OR 2.72, 95% CI = 1.58-4.69, I2 = 92%), D2 lymphadenectomy (OR 4.14, 95% CI = 2.29-7.49, I2 = 0%), perioperative blood transfusion (OR 4.21, 95% CI = 2.51-7.06, I2 = 90%), and hypertension (OR 2.21, 95% CI = 1.29-3.79, I2 = 0%). Moderate risk factors included excessive surgery duration (OR 1.51, 95% CI = 1.25-1.83, I2 = 90%), advanced age (OR 1.91, 95% CI = 1.42-2.58, I2 = 94%), nutritional status (OR 2.62, 95% CI = 1.55-4.44, I2 = 71%), and history of pulmonary disease (OR 1.61, 95% CI = 1.17-2.21, I2 = 79%).

This study identified 15 independent risk factors significantly associated with pneumonia after radical gastrectomy for gastric cancer, with a pooled prevalence of 11.0%. These findings emphasize the importance of targeted preventive strategies, including preoperative smoking cessation, nutritional interventions, blood glucose and blood pressure control, perioperative respiratory training, minimizing nasogastric tube retention time, and optimizing perioperative blood transfusion strategies. For high-risk patients, such as the elderly, those undergoing prolonged surgeries, experiencing excessive intraoperative blood loss, undergoing total gastrectomy, or receiving open surgery, close postoperative monitoring is essential. Early recognition of pneumonia signs and timely intervention can improve patient outcomes and reduce complications.

Understanding the dynamic changes in nutritional status of patients with non-Hodgkin's lymphoma (NHL) during chemotherapy is crucial, as it significantly impacts chemotherapy-related toxicity and survival outcomes.

This multi-center study included newly diagnosed NHL patients. Nutritional status and chemotherapy-related toxic effects were assessed over the first five chemotherapy sessions, with follow-ups conducted every 3 months. Patients were categorized into three groups based on pre-chemotherapy Patient-Generated Subjective Global Assessment (PG-SGA) scores: Group A (0-1), Group B (2-8), and Group C (>9). Repeated-measures ANOVA and Generalized Estimating Equations (GEE) models were used for analysis, with survival outcomes evaluated via Kaplan-Meier and Cox regression.

A total of 143 patients (mean age 50.26 ± 15.02 years) completed the study, over a median follow-up of 18.8 months. PG-SGA scores were highest in Group C during chemotherapy (P < 0.001), with significant time-group interaction effects (P < 0.001). Liver and kidney impairments worsened across all groups (P < 0.05), while gastrointestinal toxicity and bone marrow suppression initially decreased before increasing. GEE analysis showed that nutritional status positively influenced gastrointestinal toxicity (β = 0.05, P = 0.001) and bone marrow suppression (β = 0.04, P = 0.014). Malnourished patients exhibited worse pulmonary infection-free survival and overall survival (P < 0.05).

NHL patients are highly susceptible to malnutrition during chemotherapy, which exacerbates chemotherapy-related toxicities, particularly gastrointestinal effects and myelosuppression. Maintaining good initial nutrition is vital for reducing toxicities and improving survival outcomes.

To evaluate the effects of a nurse-led individualized mHealth nutrition intervention on nutritional status, nutritional intake, cognitive beliefs related to nutritional behavior, weight loss, blood parameters, gastrointestinal symptoms, and quality of life in post-discharged gastric cancer patients following gastrectomy.

This was an assessor-blinded parallel-arm randomized controlled trial with a repeated-measures design.

The participants were recruited from inpatient gastric surgery units of two tertiary hospitals in Guangzhou, China.

A total of 108 patients with gastric cancer who underwent gastrectomy and were scheduled to be discharged to their homes were included.

Participants were randomly allocated to either the intervention or the control group (n = 54 per group). The intervention group received the nurse-led individualized mHealth nutrition intervention in addition to the usual care, whereas the control group received only usual care. The intervention included face-to-face education before discharge, the use of an applet and phone consultations. Baseline data were collected on the day of discharge from the hospital (T0). The patients' nutritional status, cognitive beliefs related to nutritional behavior, nutritional intake, weight loss, blood parameters, gastrointestinal symptoms and quality of life were repeatedly measured at 4-week (T1) and 12-week (T2) after discharge.

Compared with the control group, the intervention group showed significant improvement in nutritional status (ꞵ₄ weeks = -1.08, 95 % CI -2.12 to 0.04, p = 0.042; ꞵ₁₂ weeks = -1.52, 95 % CI -2.57 to -0.47, p = 0.005). Improvements were also observed in energy and protein intake, weight loss, and cognitive beliefs related to nutritional behavior, including risk perception, outcome expectancy, self-efficacy, intention, and action plan (p < 0.05). However, no statistically significant differences were observed in coping plan, gastrointestinal symptoms, blood parameters, and quality of life (p > 0.05).

The nurse-led individualized mHealth nutrition intervention was effective for improving the cognitive beliefs related to nutritional behavior, energy and protein intake, and nutritional status, as well as reducing weight loss among post-discharged gastric cancer patients following gastrectomy.

ChiCTR2200064808.

Recent advances in immunotherapy have changed the treatment landscape for cancers of the upper gastrointestinal (GI) system. Immune checkpoint inhibitors can lead to better survival and improved quality of life for affected individuals. Adopting new treatment strategies in real-world practice can be challenging, and algorithms that are easy to implement in Canadian oncology practices would benefit clinicians and patients. In this study, we present expert opinion on best practices for upper GI cancer management, including a new algorithm that integrates the latest evidence for screening, workup, diagnosis, treatment, and survivorship. The algorithm is based on a novel approach comprising a case-based, accredited educational program with asynchronous discussion among clinicians practicing across Canada, with the input of expert medical oncologists and gastroenterologists. A needs assessment was employed to determine current areas of educational need in the field of upper GI cancers, and a patient representative provided insights into patient concerns and priorities. The best practices described here include seeking patient input throughout treatment, integrating immune checkpoint inhibitors into systemic therapy for both localized and advanced disease, and providing comprehensive supportive care throughout the treatment and survivorship journey.

Prolonged postoperative ileus (PPOI), a common complication after gastrointestinal (GI) surgery, seriously affects the postoperative recovery rate. However, there are few previous studies on the effect of preoperative nutritional status on the occurrence of PPOI in patients with GI cancer.

To evaluate the value of preoperative nutritional status for predicting the occurrence of PPOI in patients undergoing GI surgery.

We retrospectively analyzed the clinical data of GI cancer patients who were admitted to our hospital between June 2021 and June 2023. The nutritional status of all patients was assessed using the Nutritional Risk Screening 2002 (NRS2002) and the Patient-Generated Subjective Global Assessment (PG-SGA). The independent risk factors for PPOI identified via univariate and multivariate logistic regression analyses were used to establish nomogram for the prediction of PPOI.

The clinical data of 310 patients with GI cancer who underwent surgical resection were analyzed. PG-SGA score, serum albumin concentration, hemoglobin concentration, operation time, tumor stage, and previous abdominal surgery are independent risk factors for PPOI. The nomogram developed to predict PPOI performed well [area under the curve (AUC) = 0.835]. The calibration curve showed high consistency between the observed and predicted results. The decision curve analysis (DCA) revealed that the nomogram was clinically useful. The predictive ability of this nomogram is better than that of albumin level and PG-SGA score.

The preoperative nutritional status of GI cancer patients has a significant effect on the occurrence of PPOI. The nomogram developed in this study accurately predicted PPOI in GI surgery patients.

This study aims to investigate the relationship between nutritional status and quality of life (QOL) in patients with lung cancer, analyze the clinical application of nutritional support, and explore its association with biochemical markers and physical function.

A total of 270 hospitalized lung cancer patients were enrolled. Demographic characteristics, cancer staging, and treatment details were collected. Nutritional and functional status were assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS-2002), and Karnofsky Performance Status (KPS) scores. Quality of life was evaluated with the EORTC QLQ-C30 questionnaire. The relationships between nutritional status, blood biochemical markers, body composition, and quality of life were analyzed.

Among the 270 hospitalized lung cancer patients analyzed, 74.81% were male, and 80.74% were aged over 65 years. PG-SGA scores indicated that 38.89% of patients were at high nutritional risk (PG-SGA ≥ 9), and 77.04% had not received nutritional support. PG-SGA scores were significantly correlated with several biochemical indicators (e.g., prealbumin, total bilirubin, alanine aminotransferase, and lymphocyte count) and nutritional parameters (e.g., NRS-2002, KPS scores, body weight, and mid-upper arm circumference). Patients with higher PG-SGA scores had significantly lower scores in physical functioning, role functioning, emotional functioning, and social functioning, alongside more severe symptoms such as fatigue, nausea, and pain. Further analysis revealed a negative correlation between PG-SGA scores and overall health status (r = -0.687, p < 0.001) and positive correlations with symptoms such as fatigue, nausea, pain, and insomnia (r > 0.5, p < 0.001).

Nutritional status significantly impacts the quality of life in patients with lung cancer. PG-SGA scores are strongly associated with patients' functional abilities and symptom burden. Despite the low utilization of nutritional support, particularly in high-risk groups, improving nutritional interventions may effectively enhance functional status and quality of life in these patients.

To evaluate the ability of QLQ-C30 in predicting mortality in community-based cancer patients in China.

A whole-cluster sampling method was adopted to enroll cancer patients in four communities in Shanghai from 2018 to 2019. The patients were surveyed using a questionnaire enquiring demographic information, cancer types, and QLQ-C30 scale. Death information of participants was collected and updated from community health care centers. Cox regression models were used to assess the relationship between various QLQ-C30 scores (i.e., total score, five dimension scores, and utility score) and all-cause mortality.

A total of 3,304 participants were enrolled with a mean age of 63.9 years. Among them, 2,710 patients survived while 594 died by 2023. The mean total QLQ-C30 score in living patients was statistically significantly higher than that in deceased patients ( 92.96 vs. 85.21, p < 0.001); and the mean values of the five dimension scores and utility score were also significantly higher for the living patients. Cox regression models with the adjustment of covariates also confirmed that higher QLQ-C30 scores were associated with lower risk of death, with the hazard ratio value being 0.81 for the total score, 0.83-0.89 for the dimension scores, and 0.83 for the utility score, respectively (p < 0.001 for all).

QLQ-C30 could accurately predict all-cause mortality in Chinese community cancer patients.

This study aims to investigate the safety and feasibility of early oral feeding in patients with gastric cancer after gastrectomy.

A total of 135 patients with gastric cancer who would receive gastrectomy were enrolled in the study, with 61 in early oral feeding group and 74 in control group. Outcomes included nutrient intake, nutritional status, gastrointestinal functions and symptoms, pain, physical activity time, clinical outcomes and inflammation markers.

In comparison with control group, patients in early oral feeding group had significantly higher compliance rates of oral energy and protein intake, lower needs of parenteral nutrition and shorter postoperative oral feeding start time during hospitalisation. Moreover, the compliance rate of oral protein intake at 1 week after discharge was higher in patients with gastric cancer of early oral feeding group compared with control group. The gastrointestinal function was better in early oral feeding group, evidenced by shorter time to the first flatus and dwell time for gastric tube.

This study demonstrated that early oral feeding is safe and can significantly improve oral energy and oral protein intake and gastrointestinal functions during hospitalisation in patients with gastric cancer who received gastrectomy, as well as the oral protein intake after discharge.

Chinese Clinical Trial Registry: ChiCTR2300069202.

To describe the experiences of lung cancer patients undergoing chemotherapy in nutrition management and the problems in the process of implementing nutrition management for patients by healthcare professionals.

This is a qualitative descriptive study. Qualitative data were collected through semistructured interviews with lung cancer patients undergoing chemotherapy (N = 16) and healthcare professionals (N = 24) from the oncology department at three tertiary grade A hospitals.

Three themes emerged from the patients' interviews: deficiency in nutritional management capabilities; barriers to implementing nutritional management; incentives to implementing nutritional management. Five themes emerged from the healthcare professionals' interviews: insufficient attention to nutritional management of lung cancer patients undergoing chemotherapy; lack of standardization in nutritional management; inadequate support for nutritional management; weak multidisciplinary awareness; poor compliance from patients and their families.

The nutritional management of lung cancer patients undergoing chemotherapy is a complicated and vital process that requires the joint efforts of healthcare professionals and patients. Formulating corresponding strategies from multiple perspectives is suggested to provide targeted nutritional guidance for patients.

This study can help nurses better understand the nutritional management needs and challenges of patients to provide individualized nutritional guidance to patients. Meanwhile, the study also found the existing problems of nutrition management in clinical work, which can help nurses to reflect on and better participate in the nutrition management of patients.

Malnutrition is a prevalent condition among patients with gastric cancer and is associated with poor survival outcomes. This study aimed to evaluate the clinical utility of the Global Leadership Initiative on Malnutrition (GLIM) criteria in predicting survival among patients with gastric cancer. The multicenter retrospective cohort study (INSCOC study) included 1406 patients enrolled between December 2012 and April 2020, with follow-up data collected until June 2023. Various indices for muscle evaluation, such as calf circumference (CC) and body weight-standardized hand grip strength (HGS/W), were used to diagnose malnutrition. Kaplan-Meier curves were used to analyze the relationship between nutrition status, as defined by GLIM criteria, and survival outcomes in these patients. The analysis revealed that using CC or HGS/W as positive indicators of malnutrition effectively identified patients with survival-related malnutrition. The incidence of malnutrition was 54.5%, with patients' median overall survival times of 1169 days for stage I and 575 days for stage II cancer (P < 0.001). Malnutrition was identified as an independent risk factor for survival. Additionally, a nomogram developed through Cox regression analysis demonstrated precise predictive capability, incorporating factors such as tumor node metastasis staging, Karnofsky Performance Status Scale, direct bilirubin levels, and nutrition intervention. The study concludes that the GLIM criteria are effective in diagnosing malnutrition and predicting survival in patients with gastric cancer. Nutrition interventions significantly enhance survival outcomes, underscoring the importance of standardized nutrition treatments in improving patient prognosis.

Several reviews have highlighted that the Patient-Generated Subjective Global Assessment (PG-SGA) is the best diagnostic tool for assessing nutritional status in cancer patients. However, previous meta-analyses summarizing the prevalence of malnutrition and overall survival in patients with gastrointestinal (GI) cancer are quite limited. This study aims to determine the overall prevalence and association between malnutrition, as defined by the PG-SGA, and mortality in adults with GI cancer.

A comprehensive systematic review of articles published from 2005 to 2023 was conducted using Google Scholar, PubMed, Web of Sciences and Scopus. The PRISMA guideline was followed to organize the entire content. A random-effects meta-analysis model using R Studio was performed to quantify the pooled proportion and hazard ratios (HRs). Publication bias was assessed using Egger's test and funnel plots. Heterogeneity was evaluated using I2 and Baujat plots. This study was registered in PROSPERO under the protocol number CRD42023465685.

In this study, 46 publications with 23,235 participants were included in the final meta-analysis. The overall prevalence of malnutrition among adults with GI cancer, as determined by the PG-SGA, was 61% (95% CI: 51%-70%, I2 = 99%). The pooled prevalence of moderate and severe malnutrition were 38% (95% CI: 31%-45%, I2 = 96%) and 21% (95% CI: 13%-31%, I2 = 98%), respectively. By cancer type, malnutrition was more common in patients with oesophageal cancer (78%, 95% CI: 45%-94%, I2 = 99%) and gastric cancer (75%, 95% CI: 68%-81%, I2 = 87%). Additionally, the overall risk (pooled HR) of malnutrition on mortality among GI cancer patients was 2.02 (95% CI: 1.63%-2.5%, I2 = 23%).

Malnutrition is common in adults with GI cancer and doubles the risk of all-cause mortality. These results emphasize the importance of ongoing efforts in prevention, early assessment, and intervention for malnutrition to minimize mortality rates.

Malnutrition substantially contributes to adverse clinical outcomes. However, no national survey has been conducted to characterize its epidemiology in hospital settings in China. We conducted the China Nutrition Fundamental Data 2020 project among a multistage stratified cluster sample of adult inpatients from 291 study sites across 30 provinces, autonomous regions and municipalities (except for Hong Kong, Macao, Taiwan Province, and the Xizang Autonomous Region, please see MATERIALS AND METHODS for details of the causes) of China to generate reliable data on the prevalence of malnutrition and explore the associated risk factors. We collected information on participants' sociodemographic characteristics, physical examinations, and laboratory test results. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. The standardized prevalence of malnutrition was calculated, and factors associated with malnutrition were examined using logistic regression analyses. We included 54,652 individuals with seven systemic diseases who completed all the survey documents in the final analysis. The overall prevalence of malnutrition was 12.5%, representing 7.6 million adult inpatients in China. The prevalence of malnutrition was higher in men, individuals aged ⩾ 60 years, residents of central and western regions, people from lower economic areas, and those with lower education levels than in women, individuals aged <60 years, residents of eastern regions, individuals from higher economic areas, and those with higher education levels. Patients with higher disease severity scores, infectious diseases, and neoplasms had a higher tendency for malnutrition than those without such conditions. Sex, age, region, economic level, education level, disease severity score, infectious diseases, and neoplasms were independently associated with malnutrition. In conclusion, malnutrition is prevalent among Chinese adult inpatients, necessitating national- and hospital-level interventions. This survey provides several avenues to begin addressing the burden of malnutrition in China.

Numerous studies have consistently indicated a connection between the clinical results of individuals who receive immunotherapy and their nutritional condition. This study aims to evaluate the predictive capacity of the Nutritional Risk Index (NRI) in gastric cancer patients who are undergoing treatment with immune checkpoint inhibitors (ICIs). This study included a total of 146 individuals diagnosed with gastric cancer and received a combination of chemotherapy and immunotherapy using PD-1/PD-L1 inhibitors. The threshold was established by utilizing the receiver operating characteristic (ROC) curve. To analyze the clinical and pathological characteristics of the 2 groups, we performed Chi-square test or Fisher exact test. Univariate and multivariate analyses were performed to assess the factors influencing progression-free survival (PFS) and overall survival (OS) rates. Additionally, we developed nomograms to accurately predict the probability of 1- year and 3-year survival in these patients. According to the threshold, there were 38 (26.0%) patients in the low NRI category and 108 (74.0%) patients in the high NRI category. In the high NRI group, the median survival PFS was 32.50 months, while it was 11.77 months in the low NRI group. Likewise, the average survival OS in the 2 categories was 18.57 months compared to an indefinite duration. Individuals classified in the low NRI category encountered reduced PFS and OS, with a hazard ratio (HR) of 2.015 and 2.093 respectively, along with corresponding P-values of .009 and .006. The analysis of multiple variables showed that the number of platelets and TNM stage were separate factors that predicted both PFS and OS. Additionally, NRI was further recognized as a separate predictive factor for overall survival. The analysis of a specific subgroup revealed that individuals in the low NRI category experienced worse PFS and OS, especially within the group receiving ICIs. The C-index and the respective 95% CI of the nomograms to forecast the likelihood of PFS and OS survival were 0.646 (0.583-0.709) and 0.693 (0.635-0.751). NRI has the capability to forecast the clinical results of individuals who were diagnosed with gastric cancer and have received ICIs. This makes it a feasible biomarker for identifying patients who could benefit from ICIs.

To explore the efficacy of the nutritional support team (NST) management model in patients undergoing total gastrectomy combined with Roux-en-Y anastomosis.

Clinical data of 102 patients who underwent total gastrectomy combined with Roux-en-Y anastomosis in Xingtai Central Hospital from January 2020 to October 2023 were retrospectively collected. Of 102 patients, 53 received the NST model of management (NST group), while 49 were managed by the conventional nutritional support (TN group). The nutritional and immune function status of the two groups before and seven days after the surgery, postoperative rehabilitation status, and the incidence of complications were compared.

After the surgery, levels of albumin and total protein in both groups increased compared to before the surgery and were significantly higher in the NST group compared to the TN group (P<0.05). Levels of CD3+, CD4+, CD4+/CD8+ in the two groups increased compared to preoperative levels and were significantly higher than the TN group compared to the NST group. In contrast, postoperative CD8+ levels decreased and were significantly lower in the NST group (P<0.05). The duration of anal exhaust, defecation, and hospitalization in the NST group of patients was shorter (P<0.05), but no significance was found in the incidence of complications between the two groups (3.78% versus 16.33%) (P>0.05).

For patients undergoing total gastrectomy combined with Roux-en-Y anastomosis, the NST nutritional management model can effectively improve nutritional status, enhance immune function, shorten the postoperative recovery process, and the incidence of complications is equivalent to that of patients receiving conventional nutritional support.

This study aimed to compare three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer (GC).

Objective nutritional screening tools including geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were evaluated in patients with GC at our institution. Malnutrition was diagnosed according to the GLIM criteria. The diagnostic value of GNRI, PNI, and COUNT scores in identifying GLIM-defined malnutrition was assessed by conducting Receiver Operating Characteristic (ROC) curves and calculating the area under the curve (AUC). Additionally, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined. The Kappa coefficient (k) was used to assess agreement between three objective nutritional screening tools and GLIM criteria.

A total of 316 patients were enrolled in this study, and malnutrition was diagnosed in 151 (47.8%) patients based on the GLIM criteria. The GNRI demonstrated good diagnostic accuracy (AUC = 0.805, 95% CI: 0.758-0.852) for detecting GLIM-defined malnutrition, while the PNI and COUNT score showed poor diagnostic accuracy with AUCs of 0.699 (95% CI: 0.641-0.757) and 0.665 (95% CI: 0.605-0.725) respectively. Among these objective nutritional screening tools, the GNRI-based malnutrition risk assessment demonstrated the highest specificity (80.0%), accuracy (72.8%), PPV (74.8%), NPV (71.4%), and consistency (k = 0.452) with GLIM-defined malnutrition.

Compared to PNI and COUNT scores, GNRI demonstrated superior performance as an objective nutritional screening tool for identifying GLIM-defined malnutrition in GC patients.

Gastric cancer (GC), a malignant tumor, is highly prevalent, particularly in Asia. miR-509-3p plays a crucial role in regulating tumorigenesis, but its mechanism in GC remains unclear. Potential targets of miR-509-3p were identified through database analyses (miRWalk, TargetScan, ENCORI, and TCGA). The binding site between miR-509-3p and forkhead box protein M1 (FOXM1) was confirmed using a dual-luciferase assay. CCK-8, EdU, Transwell, wound healing assays, flow cytometry, and Western blot analysis were employed to examine changes in proliferation, migration, invasion, apoptosis, FOXM1, and the p38 MAPK (p38)/MAPK-activated protein kinase 2 (MK2) pathway in GC cells (MNK-45 and HGC-27) after miR-509-3p overexpression or knockdown, FOXM1 overexpression, and application of the p38 pathway agonist Anisomycin. The size and weight of subcutaneous xenografts were measured, and the effects of miR-509-3p overexpression were analyzed through histopathological staining (Tunel immunofluorescence, HE staining, Ki67, and FOXM1 immunohistochemistry). The results showed that overexpression of miR-509-3p suppressed proliferation, migration, and invasion, while accelerating apoptosis. Knockdown of miR-509-3p promoted malignant progression. miR-509-3p inhibited GC by regulating FOXM1-mediated p38/MK2 pathway activation, and miR-509-3p mimics restrained tumor growth in vivo through this pathway. In conclusion, miR-509-3p suppresses GC malignant progression by regulating FOXM1-mediated p38/MK2 pathway activation.

Malnutrition is a significant public health issue for patients with gastric cancer, particularly in East Asia, the region most affected globally. In response to the absence of adequate tools for assessing nutritional status, the Global Leadership Initiative on Malnutrition (GLIM) criteria were established in 2018, aiming to standardize the diagnosis of malnutrition. However, there is no consensus on the value of GLIM criteria for evaluating the nutritional status of patients with gastric cancer in East Asia. Given these facts, our study aimed to assess the validity of the GLIM criteria in East Asian patients with gastric cancer.

We conducted a rapid critical review of available literature, summarizing the existing problems in GLIM applications and possible improvement directions. After systematically summarizing the literature published in PubMed, Web of Science, and Cochrane Library, a total of 13 articles involving 7,679 cases were included in this study.

The results indicated a lack of sufficient data on sensitivity and specificity to fully validate the GLIM criteria for diagnosing malnutrition in East Asian patients with gastric cancer. Additionally, some studies have reported moderate agreement between the GLIM and the PG-SGA. Furthermore, malnutrition defined by GLIM is a risk factor for short and long-term outcomes in East Asian patients with gastric cancer. However, the prognostic effect of moderate malnutrition on these patients remains controversial.

Despite being in the early application stages, GLIM has shown promising potential in diagnosing and predicting the prognosis of malnutrition. However, future research should incorporate more comprehensive validity parameters, including sensitivity, specificity, and PPV/NPV, to achieve a more thorough understanding of GLIM's diagnostic efficacy. Furthermore, further optimization of GLIM is necessary to address the needs of more diverse populations and situations.

The prognostic effects of the Patient-Generated Subjective Global Assessment (PG-SGA) criteria in cancer survivors have been observed but require validation in clinical practice. This study was designed to evaluate the prognostic effects of baseline and longitudinal changes in PG-SGA scores on all-cause mortality among Chinese cancer patients in a real-world setting.

Study patients were selected from one representative tertiary hospital in West China. Kaplan-Meier curves and Cox regression analyses were used to estimate the prognostic effect of baseline and dynamic changes in PG-SGA scores on the all-cause mortality of cancer patients. Receiver operating characteristic curves and a concordance index were used to evaluate the predictive accuracy of PG-SGA criteria.

A total of 1415 cancer patients were included in this study, with a mean age of 46 years old. Cox regression analysis showed that baseline malnourished status was significantly associated with the survival of cancer patients (PG-SGA 4-8: hazard ratio [HR] = 1.46, 95% confidence interval [CI]: 1.09-1.96, P = 0.012; PG-SGA ≥9: HR = 1.78, 95% CI: 1.34-2.37, P < 0.001). Cancer patients with longitudinal increased PG-SGA scores (>2 points) were observed to have high risks for mortality (HR = 1.69, 95% CI: 1.04-2.74, P = 0.033). Compared with longitudinal changes in PG-SGA scores, baseline malnourished status showed higher predictive power in identifying the risk subgroup (concordance index: 0.646 vs. 0.586). Sensitivity analyses supported the main findings.

This study highlights the prognostic value of baseline and dynamic changes in PG-SGA scores for cancer patients, which can help improve their outcomes.

To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care.

This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: "Do you have difficulty or problems swallowing?". Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and systemic instability, or if data collection instruments were incomplete. Two instruments were used in their Brazilian Portuguese versions: the Palliative Performance Scale (PPS) and the M. D. Anderson Dysphagia Inventory (MDADI). The variables were analyzed using descriptive and inferential statistics, with Pearson's correlation used at a 5% significance level.

The sample consisted of 39 participants, with an average age of 65.3 years, of whom 24 (61.5%) were women. The most frequent neoplasm sites were the pancreas and stomach. The results of the PPS indicated that the average patient had reduced ambulation and inability to work, but maintained independence in self-care, with a complete level of swallowing and consciousness. The MDADI showed an average degree of limitation. Outpatients exhibited a moderate correlation between the MDADI result and the level of functionality according to the PPS.

Cancer patients at the palliative care outpatient clinic demonstrated a correlation between functional performance and the impact of dysphagia on quality of life.

Introduction: symptom clusters (SCs) are highly prevalent among patients diagnosed with primary liver cancer. Malnutrition poses a heightened risk for a more pronounced total symptom cluster score. Objective: this study aimed to identify SCs and assess the nutritional status of patients undergoing transcatheter arterial chemoembolization (TACE). Furthermore, it aimed to investigate the association between nutritional status and symptom clusters. Methods: primary liver cancer patients who were scheduled to receive TACE were recruited. Symptoms data were collected using the MD Anderson Symptom Inventory (MDASI-C) and the Symptom Module specific to Primary Cancer (TSM-PLC). Nutritional assessment relied on the Nutritional Risk Screening-2002 (NRS-2002) and blood biochemistry. The SCs were extracted using exploratory factor analysis, while the relationship between SCs and nutritional status was evaluated using Spearman correlation analysis. Results: the study included 226 patients, four distinct symptom clusters emerged: emotional-psychological symptom cluster, upper gastrointestinal symptom cluster, post-embolization-related symptom cluster, and liver function impairment symptom cluster. 68.14 % of patients were found to be at high risk of malnutrition. Our study revealed significant differences in Scs scores between patients at risk of malnutrition and those without such risk (p < 0.050). Notably, we observed a positive correlation between NRS-2002 scores and the scores of all symptom clusters (r = 0.205 to 0.419, p < 0.001), while a negative correlation was observed between prealbumin levels and the scores of all symptom clusters (r = -0.183 to -0.454, p < 0.001). Conclusion: the study highlights the high risk of malnutrition among liver cancer patients receiving TACE and the positive correlation between high malnutrition risk and Scs scores.

Although the Patient-Generated Subjective Global Assessment (PG-SGA) is a reference standard used to assess a patient's nutrition status, it is cumbersome to administer. The aim of the present study was to estimate the value of a simpler and easier-to-use modified PG-SGA (mPG-SGA) to evaluate the nutrition status and need for intervention in patients with malignant tumors present in at least two organs.

A total of 591 patients (343 male and 248 female) were included from the INSCOC study. A Pearson correlation analysis was conducted to assess the correlation between the mPG-SGA and nutrition-related factors, with the optimal cut-off defined by a receiver operating characteristic curve (ROC). The consistency between the mPG-SGA and PG-SGA was compared in a concordance analysis. A survival analysis was used to determine the effects of nutritional intervention among different nutrition status groups. Univariable and multivariable Cox analyses were applied to evaluate the association of the mPG-SGA with the all-cause mortality.

The mPG-SGA showed a negative association with nutrition-related factors. Individuals with an mPG-SGA ≥ 5 (rounded from 4.5) were considered to need nutritional intervention. Among the malnourished patients (mPG-SGA ≥ 5), the overall survival (OS) of those who received nutrition intervention was significantly higher than that of patients who did not. However, the OS was not significantly different in the better-nourished patients (mPG-SGA < 5).

Our findings support that the mPG-SGA is a feasible tool that can be used to guide nutritional interventions and predict the survival of patients with malignant tumors affecting at least two organs.

Older patients with cancer have a higher risk for malnutrition and impaired quality of life (QoL). The present study aimed to investigate the relationship between malnutrition diagnosed according to the Global Leadership Initiative Malnutrition (GLIM) criteria and QoL across various tumor types, and to evaluate the combined prognostic value of malnutrition and QoL in predicting survival among older patients with cancer.

This multicenter, observational cohort study included 5310 older patients with cancer and 2184 with malnutrition (moderate stage, n = 1023; severe stage, n = 1161). An empirical cumulative distribution curve was performed to illustrate the correlation between malnutrition and QoL. The primary objective was to investigate the association between malnutrition and QoL using logistic regression analysis. Survival analyses were performed to assess the combined prognostic value of malnutrition and QoL.

The median age of the patients (66.9% male, 33.1% female) was 70 years (interquartile range [IQR] 67-74 years) years. The median QoL score was highest in patients without malnutrition (91.88 [IQR 84.44-97.44]), followed by those with moderate (86.15 [IQR 76.18-93.85) and severe (82.31 [IQR 69.87-91.11]) malnutrition. Logistics regression revealed that the risk for developing impaired QoL increased 1.98 (95% confidence interval [CI] 1.64-2.38; P < 0.001) and 2.33 (95% CI 1.93-2.81; P < 0.001) times in patients with moderate and severe malnutrition, respectively. Kaplan-Meier curves showed that QoL in combination with GLIM criteria demonstrated a significant discriminative performance for survival and served as an independent prognostic factor among older patients with cancer, especially for lung and gastric cancers.

Malnutrition diagnosed according to the GLIM criteria was a predictor of impaired QoL. Additionally, the combination of QoL and malnutrition demonstrated utility for predicting survival outcomes in older patients with cancer.

It is well established that the preoperative nutritional status of gastric cancer (GC) patients significantly affects the prognosis of the operated patients, their overall survival, as well as the disease-specific survival. Existing data support that preoperative assessment of nutritional status and early correction of nutritional deficiencies exert a favorable effect on early postoperative outcomes. A variety of relevant indices are used to assess the nutritional status of GC patients who are candidates for surgery. The guidelines of almost all international organizations recommend the use of oral enteral nutrition (EN). Oncologically acceptable types of gastrectomy and methods of patient rehabilitation should take into account the expected postoperative nutritional status. The majority of data support that perioperative EN reduces complications and hospital stay, but not mortality. Oral EN in the postoperative period, albeit in small amounts, helps to reduce the weight loss that is a consequence of gastrectomy. Iron deficiency with or without anemia and low serum levels of vitamin B12 are common metabolic sequelae after gastrectomy and should be restored. EN also significantly helps patients undergoing neoadjuvant or adjuvant antineoplastic therapy. The occurrence of the so-called "postgastrectomy syndromes" requires dietary modifications and drug support. This review attempts to highlight the benefits of EN in GC patients undergoing gastrectomy and to emphasize the type of necessary nutritional management, based on current literature data.

Quality of life (QoL), appetite, cachexia, and biomarkers [albumin, hemoglobin (Hb), neutrophils, lymphocytes, platelets, C-reactive protein (CRP), tumor necrosis factor alpha (TNFα), interleukin 6 (IL-6), interleukin 8 (IL-8), C-X-C motif chemokine ligand 5 (CXCL5) and citrullinated histoneH3 (H3Cit)] were compared for 40 cases with advanced cancer and 40 healthy controls. Baseline differences and significant relationships were explored for biomarkers with QoL, appetite, and cachexia.

In a prospective case-control, age and sex matched study, the European Organisation for the Research and Treatment of Cancer Quality of Life-C30 questionnaire (EORTC-QLQ-C30) for QoL, the Functional Assessment of Anorexia and Cachexia Therapy assessment (FAACT A/CS-12) for appetite, and a five-factor cachexia assessment tool for cachexia assessment were performed. Routine hematological measurements and blood chemistry analyses together with ELISA procedures and a Multiplex® bead array platform, were used for biomarker analysis. Descriptive statistics and regression analyses were undertaken. P < 0.05 defined statistical significance.

Global health status (QL-G), functional scales (QL-FS), and symptom scales (QL-SS) differed for cases and controls (p < 0.01). In cases, differences were observed for QL-G (p < 0.01), QL-FS (p < 0.01), and QL-SS (p = 0.01) compared to standardized references values. FAACT A/CS-12 scores differed significantly between cases and controls (p < 0.01) and 30% of cases scored "poor" appetites. Cachexia was present in 60% of cases. Albumin, lymphocytes, platelets, Hb, platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), CRP, TNFα, all at p < 0.01, neutrophil to lymphocyte ratio (NLR) (p = 0.02), IL-6 (p < 0.04), and IL-8 (p = 0.02) differed significantly between cases and controls. No difference was found for CXCL5 or H3Cit. Albumin NLR, Hb, PLR, SII, TNFα, IL-8, and CRP showed significant relationships with all aspects of QoL. QL-FS was significantly related to CXCL5 (p = 0.04), significant relationships with FAACT A/CS-12 included: NLR (p = 0.002), Hb (p < 0.001), and PLR (p < 0.01). NLR, PLR, SII, TNFα, IL-6, IL-8, and CRP correlated positively to cachexia and albumin while Hb and lymphocyte count correlated negatively to cachexia.

CXCL5 and H3Cit were not reliable biomarkers for cancer cachexia, nor significantly related to QoL, appetite or cachexia. Albumin, NLR, Hb, PLR, SII, TNFα, IL-8, and CRP were reliable indicators of QoL, appetite, and cachexia. Future research should include other novel biomarkers namely growth differentiation factor-15 (GDF-15), fibroblast growth factor 21 (FGF-21), fractakline, interferon gamma (IFN-y), IL-16, macrophage colony stimulating factor (M-CSF), and macrophage procoagulant-inducing factor (MPIF).

The nutritional status is closely linked to the immune function of patients. Previous studies have demonstrated the utility of the Geriatric Nutritional Risk Index (GNRI) in assessing nutritional status. The aim of this study is to investigate the prognostic significance of GNRI in patients with gastric cancer who received immune checkpoint inhibitor (ICI) therapy. The study enrolled 89 gastric cancer patients who received different types of immune checkpoint inhibitors (ICIs) between August 2016 and December 2020, along with 57 patients who underwent chemotherapy during the same period as a control group. The GNRI cutoff point was established based on prior research. Differences in clinical and pathological features were analyzed using the Chi-square test or independent samples t-test. Univariate and multivariate analyses were used to identify prognostic factors for both progression-free survival (PFS) and overall survival (OS). Furthermore, nomograms were created to predict the likelihood of patient survival. There were 31 cases (21.2%) with GNRI < 92.00 and 115 cases (78.8%) with GNRI ≥ 92.00. Patients with low GNRI had significantly shorter PFS (21.33 months vs 28.37 months, P = .001) and OS (33.06 months vs 41.63 months, P = .001) than those with high GNRI, among all patients. Similar results were also found in patients treated with ICIs. Additionally, GNRI was identified as an independent prognostic factor. The C-index and 95% CI of the nomograms for predicting survival probabilities were 0.667 (0.600-0.735) and 0.685 (0.622-0.749), respectively. GNRI was significantly associated with survival time in patients with gastric cancer who received ICIs, patients with low GNRI had shorter PFS and OS. GNRI might be able to identify patients who might benefit from ICIs.

Malnutrition is prevalent among individuals with gastric cancer and notably decreases their quality of life (QOL). However, the factors impacting QOL are yet to be clearly defined. This study aimed to identify essential factors impacting QOL in malnourished patients suffering from gastric cancer.

By using the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status (≥4 defined malnutrition) of hospitalized cancer patients, 4,586 gastric cancer patients were ultimately defined as malnourished. Spearman method was used to calculate the relationship between clinical features and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Then, univariate and multivariate logistic regression were used to observe which factors affected QOL, and subgroup analysis was performed in young and old population respectively. In addition, we used univariate and multivariate logistic regression to explore whether and how self-reported frequent symptoms in the last 2 weeks of the PG-SGA score affected QOL.

In multivariate logistic regression analysis of clinical features of patients with malnourished gastric cancer, women, stage II, stage IV, WL had an independent correlation with a low global QOL scores. However, BMI, secondary education, higher education, surgery, chemotherapy, HGS had an independent correlation with a high global QOL scores. In multivariate logistic regression analysis of symptoms in self-reported PG-SGA scores in patients with malnourished gastric cancer, having no problem eating had an independent correlation with a high global QOL scores. However, they have no appetite, nausea, vomiting, constipation and pain had an independent correlation with a lower global QOL scores. The p values of the above statistical results are both < 0.05.

This study demonstrates that QOL in malnourished patients with gastric cancer is determined by female sex, stage II, stage IV, BMI, secondary and higher education or above, surgery, chemotherapy, WL, and HGS. Patients' self-reported symptoms of nearly 2 weeks, obtained by using PG-SGA, are also further predictive of malnourished gastric cancer patients. Detecting preliminary indicators of low QOL could aid in identifying patients who might benefit from an early referral to palliative care and assisted nursing.

We conducted a multicenter cross-sectional study in central and western China to explore the association between inflammatory diet and stomach cancer odds.

Participants from five hospitals in the central and western regions were collected. All participants completed the questionnaire we provided before the gastroscopy examination, which includes inquiries about risk factors for stomach cancer and food frequency. All participants underwent gastroscopy, and a mucosal biopsy was confirmed pathologically. Pathological findings were classified as chronic gastritis group, precancerous lesions group and stomach cancer group. Dietary Inflammatory Index (DII) scores were calculated based on the frequency of food occurrences in the questionnaire, and finally SPSS was used to calculate the correlation between variables.

A total of 1162 patients were included in this study, including 668 cases of chronic gastritis, 411 cases of precancerous lesions, and 83 cases of cancer. A single factor analysis was conducted to examine the risk factors of stomach cancer, revealing a significant association between a pro-inflammatory diet and the stomach cancer odds (p value < 0.05). The results of binary classification analysis further confirmed that a pro-inflammatory diet is a risk factor for stomach cancer 【odds ratio (OR) =7.400)】. Moreover, correlation analysis demonstrated a positive correlation between the severity of gastric mucosal diseases and an inflammatory diet (including anti-inflammatory and pro-inflammatory diets) (rs=0.274, p-value < 0.001).

Pro-Inflammatory diet is a risk factor for stomach cancer, and may accelerate the progression of stomach mucosal disease.

Malnutrition is prevalent among gastric cancer (GC) patients, necessitating early assessment of nutritional status to guide monitoring and interventions for improved outcomes. We aim to evaluate the accuracy and prognostic capability of three nutritional tools in GC patients, providing insights for clinical implementation.

The present study is an analysis of data from 1308 adult GC patients recruited in a multicenter from July 2013 to July 2018. Nutritional status was assessed using Nutritional Risk Screening 2002 (NRS-2002), Patient-Generated Subjective Global Assessment (PG-SGA) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Bayesian latent class model (LCM) estimated the malnutrition prevalence of GC patients, sensitivity and specificity of nutritional tools. Cox regression model analyzed the relationship between nutritional status and overall survival (OS) in GC patients.

Among 1308 GC patients, NRS-2002, PG-SGA, and GLIM identified 50.46%, 76.76%, and 68.81% as positive, respectively. Bayesian LCM analysis revealed that PG-SGA had the highest sensitivity (0.96) for malnutrition assessment, followed by GLIM criteria (0.78) and NRS-2002 (0.65). Malnutrition or being at risk of malnutrition were identified as independent prognostic factors for OS. Use any of these tools improved survival prediction in TNM staging system.

PG-SGA is the most reliable tool for diagnosing malnutrition in GC patients, whereas NRS-2002 is suitable for nutritional screening in busy clinical practice. Given the lower sensitivity of NRS-2002, direct utilization of GLIM for nutritional assessment may be necessary. Each nutritional tool should be associated with a specific course of action, although further research is needed.

Nutrition impact symptoms and unintended weight loss are prevalent in patients with gastrointestinal cancers, especially during the perioperative period or while prescribed anticancer treatments. Because patients may experience loss of lean body mass and malnutrition, aggressive nutrition intervention prior to surgery should be considered. Cancer prehabilitation is a process spanning the care continuum from diagnosis to the time of surgery encompassing nutrition support, psychological and physical assessment, and targeted interventions. Thirteen studies published between 2013 and 2023 were included in this review and evaluated prehabilitation programs' impact on postoperative outcomes in patients with gastrointestinal cancers. Literature continues to emerge supporting the integration of nutrition into a prehabilitation program because of its potential to contribute to improved clinical outcomes, quality of life, and cost-effectiveness, but considerable variation exists with respect to the specific recommendations provided by current prehabilitation programs.

Malnutrition is prevalent among cancer patients, smartphone-based self-administered nutritional assessment tools offer a promising solution for effective nutritional screening. This study aims to retrospectively analyze the relationships between nutritional status evaluated by the digital tool (R+ Dietitian) and clinicopathologic factors of cancer patients.

Cancer patients who met the inclusion criteria were divided into two subgroups based on age, Nutritional Risk Screening-2002, Patient-Generated Subjective Global Assessment Short Form, body mass index, and hospital stays for comparison. Correlation and regression analysis were used to comprehensively assess the relationship between nutritional status and clinicopathologic factors.

A total of 535 hospitalized cancer patients (58.32 ± 11.24 years old) were recruited. Patients identified with nutritional risk assessed by R+ Dietitian were significantly older, had lower body weight, lower body mass index, greater weight loss, and longer hospital stays (all of above, P < 0.01). Multiple logistic regression analysis indicated that serum prealbumin concentration (odds ratio: 0.992, 95% confidence interval: 0.987-0.997, P = 0.001), weight loss (odds ratio: 7.309, 95% confidence interval: 4.026-13.270, P < 0.001), and body mass index < 18.5 (odds ratio: 5.882, 95% confidence interval: 2.695-12.821, P < 0.001) predicted nutritional risk indicated by Nutritional Risk Screening-2002 score ≥3. Hemoglobin concentration (odds ratio: 0.983, 95% confidence interval: 0.970-0.996, P = 0.011), weight (odds ratio: 1.111, 95% confidence interval: 1.056-1.169, P < 0.001), weight loss (odds ratio: 7.502, 95% confidence interval: 4.394-12.810, P < 0.001), body mass index (odds ratio: 0.661, 95% confidence interval: 0.564-0.775, P < 0.001), and energy intake (odds ratio: 0.996, 95% confidence interval: 0.995-0.997, P < 0.001) predicted nutritional risk indicated by Patient-Generated Subjective Global Assessment Short Form score ≥4. Multiple linear regression analysis revealed that Patient-Generated Subjective Global Assessment Short Form scores ≥3 (b = 2.032, P = 0.008) were significantly associated with longer hospital stays.

The nutritional risks assessed by R+ Dietitian accurately reflected the characteristics of malnutrition in cancer patients and predicted hospital stay and cost, indicating the applicability of R+ Dietitian to improving the efficiency of nutritional management for cancer patients.

Malnutrition and cachexia are common syndromes in patients with gastric cancer (GC) and are associated with poor quality of life and poor disease prognosis. However, there is still a lack of molecular factors that can predict malnutrition or cachexia in cancer. Studies have shown that among the potential contributors to the development of cancer cachexia, the level of the inflammatory response to P-selectin is regulated by single nucleotide polymorphisms (SNPs) located in the promoter region of the SELP gene. The aim of this study was to evaluate the association between the single nucleotide polymorphism (SNP)-2028 A/G of the SELP gene and malnutrition in patients receiving chemotherapy for gastric cancer (GC).

The study group consisted of 220 GC patients treated with chemotherapy at Jinhua Municipal Central Hospital. DNA was extracted from peripheral leukocytes of whole blood samples using an animal DNA extraction kit. DNA was amplified using a 1.1 × T3 Super PCR mix, and loci corresponding to the peaks were genotyped using SNP1 software.

Patients carrying the A allele had a reduced risk of developing malnutrition compared to patients with the GG genotype (P < 0.001; OR = 3.411; 95% CI = 1.785-6.516). In addition, multivariate analysis indicated that the AA genotype significantly (more than 16-fold) reduced the risk of developing malnutrition (P < 0.001; OR = 0.062; 95% CI = 0.015-0.255).

SELP -2028A/G SNP may be a useful marker for assessing the risk of malnutrition in GC patients.

Patients with gastrointestinal tumors often suffer from poor nutritional status during treatment. Surgery is the main treatment for these patients, but the long postoperative recovery period is often accompanied by digestive and absorption dysfunction, leading to further deterioration of the nutritional status. Early enteral nutrition support is hypothesized to be helpful in improving this situation, but the exact effects have yet to be studied in depth.

To observe the effect of early enteral nutritional support on postoperative recovery in patients with surgically treated gastrointestinal tract tumors, with the expectation that by improving the nutritional status of patients, the recovery process would be accelerated and the incidence of complications would be reduced, thus improving the quality of life.

A retrospective analysis of 121 patients with gastrointestinal tract tumors treated in our hospital from January 2020 to January 2023 was performed. Fifty-three of these patients received complete parenteral nutrition support as the control group for this study. The other 68 patients received early enteral nutritional support as the observation group of this study. The clinical indicators comparing the two groups included time to fever, time to recovery of postoperative bowel function, time to postoperative exhaustion, and length of hospital stay. The changes in immune function and nutritional indexes in the two groups were compared. Furthermore, we utilized the SF-36 scale to compare the changes in the quality of life between the two groups of patients. Finally, the occurrence of postoperative complications between the two patient groups was also compared.

The postoperative fever time, postoperative bowel function recovery time, postoperative exhaustion time, and hospitalization time were all higher in the control group than in the observation group (P < 0.05). The levels of CD3+, CD4+, immunoglobulin (Ig) A, IgM, and IgG in the observation group were significantly higher than those in the control group at 1 d and 7 d postoperatively, while CD8+ was lower than in the control group (P < 0.05). Total protein, albumin, prealbumin, and transferrin levels were significantly higher in the observation group than in the control group at 7 d postoperatively (P < 0.05). The SF-36 scores of patients in the observation group were significantly higher than those in the control group (P < 0.0001). The overall incidence of adverse reactions after the intervention was significantly lower in the control group than in the observation group (P = 0.021).

We found that patients with gastrointestinal tumors are nutritionally vulnerable, and early enteral nutrition support programs can improve the nutritional status of patients and speed up postoperative recovery. This program can not only improve the immune function of the patient and protect the intestinal function, but it can also help to improve the quality of life of the patient. However, this program will increase the incidence of complications in patients. Caution should be taken when adopting early enteral nutrition support measures for patients with gastric cancer. The patient's condition and physical condition should be comprehensively evaluated and closely monitored to prevent possible complications.

Using grip strength as a predictor of nutritional risk and early ambulation for gastrointestinal tumor surgery and determining its critical value have not been reported. This study was designed to explore the influencing factors of early postoperative ambulation ability for patients with gastrointestinal tumors who underwent laparoscopic surgery.

Four-hundred twenty-seven patients with gastrointestinal tumors who underwent laparoscopic surgery at three tertiary A hospitals in Beijing were prospectively enrolled. Subsequently, logistic regression analysis was conducted to determine the independent predictors of early postoperative ambulation. Logistic regression analyses for the different gender were also performed. In addition, the effectiveness of preoperative grip strength measurement in nutritional risk assessment was analyzed by using nutritional risk score 2002 (NRS 2002) as a control.

The included cases were comprised of 283 male and 144 female patients, with an age of 59.35 ± 11.70 years. Gender, preoperative grip strength, operative time, and number of indwelling tubes were independent predictors of early postoperative ambulation. In the male group, lower preoperative grip strength and more indwelling tubes were independent risk factors for early postoperative ambulation. In the female group, lower preoperative grip strength and extended operating time were independent risk factors. Moreover, preoperative grip strength (male < 32 kg, female < 21 kg) can be used as a risk predictor for both preoperative nutritional risk and early postoperative ambulation.

As a simple and objective measure of muscle strength, grip strength measurement is expected to be an effective predictor for both early postoperative ambulation ability and nutritional status of patients.

Objective: This study aimed to summarize the current evidence-based approach to perioperative enteral nutritional (EN) program for gastric cancer (GC) surgery and to develop a staged and operable EN management scheme based on the evidence to provide clinical guidance for improving perioperative EN management in patients with GC.Methods: First, we synthesized expert consensuses, systematic reviews, and guidelines related to GC patients who had undergone surgery, based on a review of the literature and expert meetings. Subsequently, after carefully evaluating and selecting relevant EN management data, we created a preliminary draft of a perioperative EN program. Following Delphi expert consultations, the final version of the perioperative EN program was constructed after revision.Results: After two rounds of consultation, the expert opinions tended to be consistent. The expert positive coefficient was 1.00, and the expert authority coefficient was 0.90. After the second round of consultation, the coefficient of variation of the importance score ranged from 0.05 to 0.20, and the coefficient of variation of the feasibility score ranged from 0.09 to 0.23. The Kendall harmony coefficients were 0.338 and 0.392, and the difference between them was statistically significant (p < 0.001). The final practice plan includes 4 first-level, 16 s-level, and 64 third-level items.Conclusions: The perioperative EN program constructed in this study is comprehensive in content, feasible, and evidence-based, and can provide insights for clinical improvement.

Malnutrition is a complex clinical syndrome, the exact mechanism of which is yet not fully understood. Studies have found that malnutrition is associated with anorexia and inadequate intake, tumor depletion, leptin, tumor-induced metabolic abnormalities in the body, and catabolic factors produced by the tumor in the circulation and cytokines produced by the host immune system. Among these, single nucleotide polymorphisms (SNPs) are present in the gene encoding the pro-inflammatory cytokine TNF-α.