Comparison of laparoscopic and open radical gastrectomy for gastric cancer patients with GLIM-defined malnutrition |
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| Affiliation: | 1. Department of Nursing, Shanghai Proton and Heavy Ion Center, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China;2. Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institution, Liaoning, China;3. School of Nursing, Southern Medical University, Guangzhou, China;1. Institute of Biopharmaceutical, Liaocheng University, Liaocheng, China;2. Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China;3. Department of Oncology, Capital Medical University, Beijing, China;4. Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China;5. Liaocheng High-tech Biotechnology Co., Ltd., Liaocheng, China;6. Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, China;7. Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China |
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| Abstract: | PurposeMalnutrition is common in the patients with gastric cancer. Radical gastrectomy remained the primary strategy of curable treatment for gastric cancer. This study is performed to explore the effect of laparoscopic radical gastrectomy on clinical outcomes in gastric cancer patients with malnutrition.MethodsGastric cancer patients with GLIM-defined malnutrition between 2014 and 2019 at our center were enrolled. The patients were divided into two groups according to the different type of surgery. Propensity score match analysis was used to balance the clinicopathologic characteristics of two groups. Postoperative outcomes and survival were compared. Multivariate analysis was used to independent risk factors of complication, overall survival (OS), and disease-free survival (DFS).ResultsCompared with patients underwent open radical gastrectomy, patients who underwent laparoscopic radical gastrectomy had lower rate of total, surgical and severe complications. They also had shorter postoperative hospital stay with better OS and DFS. Hypoalbuminemia (P = 0.003) was the independent risk factor of complications. Old age (≥75, P = 0.035) and TNM stage (III: P < 0.001, II: P = 0.015) were the independent risk factors of OS. Combined resection (P = 0.003) and TNM stage (III: P < 0.001, II: P = 0.001) posed independent risk factors of lacking DFS. Laparoscopic surgery proved to be the independent protective factor of complications (P = 0.014), OS (P < 0.001) and DFS (P < 0.001).ConclusionLaparoscopic radical gastrectomy was relative safe and showed favorable outcomes in malnourished gastric cancer patients. |
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| Keywords: | Gastric cancer GLIM Malnutrition Laparoscopic gastrectomy Prognosis |
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