Impact of GLIM Defined Malnutrition on Long Term Prognosis in Patients With Gastric Cancer After Gastrectomy
Ryota Matsui, Noriyuki Inaki, Toshikatsu Tsuji
Abstract
BACKGROUND/AIM: Although the global leadership initiative on malnutrition (GLIM) criteria for malnutrition were published in 2018, few studies have correlated them with postoperative outcomes of gastric cancer. This study aimed to investigate the validity of predicting prognosis after gastrectomy in patients with advanced gastric cancer by dividing the patients according to the severity of malnutrition using the body mass index (BMI) and body weight loss (BWL), as defined by the GLIM criteria. PATIENTS AND METHODS: This study included patients with c-stage II-III primary gastric cancer who underwent gastrectomy between April 2008 and June 2018. Patients were divided into normal, moderate malnutrition, and severe malnutrition groups according to the GLIM criteria of BMI and BWL. The primary endpoint was overall survival (OS). RESULTS: Of the 512 patients, 340 (66.4%) were included in the normal group, 84 (16.4%) in the moderate group, and 88 (17.2%) in the severe group. Comparing the long-term prognosis in the three groups, the prognosis was worse in the moderate and severe groups than in the normal group for OS (p<0.001). Multivariate analysis for OS showed that moderate malnutrition [hazard ratio (HR)=1.689, 95% confidence interval (CI)=1.017-2.576, p=0.015] and severe malnutrition (HR=1.918, 95% CI=1.275-2.884, p=0.002) were independent poor prognostic factors. CONCLUSION: Using two simple indices from the GLIM criteria, preoperative BMI and BWL, this study found that moderate and severe malnutrition were independent poor prognostic factors for OS.