The relationship between the GLIM-defined malnutrition,body composition and functional parameters,and clinical outcomes in elderly patients undergoing radical gastrectomy for gastric cancer |
| |
| Institution: | 1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;2. Department of General Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;3. First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, China;4. Department of Gastrointestinal Surgery, Shanghai Tenth People''s Hospital, School of Medicine, Tongji University, Shanghai, China;1. Colorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia;2. Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia;3. Department of Surgery, Amsterdam University Medical Centers, Location VUmc, Amsterdam, the Netherlands;4. Department of Surgical Oncology, Division of Surgery, MD Anderson Cancer Center, Houston, TX, USA;1. Department of Plastic Surgery, Herlev and Gentofte Hospital, Copenhagen, Denmark;2. Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark;3. Department of Clinical Physiology, Nuclear Medicine and PET, Herlev and Gentofte Hospital, Copenhagen, Denmark;4. Department of Radiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark;5. Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia;6. Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia;7. Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia |
| |
| Abstract: | ObjectiveThe present study aims to determine the correlations between Global Leadership Initiative in Malnutrition (GLIM)-defined malnutrition and body composition and functional parameters, and to comprehensively analyze the predictive value of GLIM-defined malnutrition for postoperative outcomes in the context of detailed measurement of body composition and functional parameters in elderly patients who underwent radical gastrectomy for gastric cancer.MethodsElderly patients (aged ≥65 years) who underwent radical gastrectomy for gastric cancer from August 2014 to June 2019 were included. Malnutrition was diagnosed using the GLIM criteria. Skeletal muscle index (SMI), skeletal muscle density (SMD), subcutaneous fat area (SFA), and visceral fat area (VFA) were analyzed using abdominal computed tomography (CT) images. Handgrip strength and 6-m gait speed were measured.ResultsA total of 597 elderly patients were included in this study, in which 45.7% were at risk of malnutrition identified using Nutritional Risk Screening 2002 (NRS 2002), and 34.5% were diagnosed with malnutrition. Patients with malnutrition had lower SMI, SMD, SFA, VFA, lower handgrip strength and gait speed. Low handgrip strength and age ≥80 years were independent risk factors for postoperative complications, rather than GLIM-defined malnutrition. GLIM-defined malnutrition was independently associated with overall survival and disease-free survival after adjusting to the body composition and functional parameters in the multivariate analyses.ConclusionsGLIM-defined malnutrition was a better predictive factor than single parameters of body composition or physical function for survival in elderly gastric cancer patients. Handgrip strength can be used as a supportive measure to further improve the definition of malnutrition. |
| |
| Keywords: | Malnutrition Body composition Physical function Gastric cancer Clinical outcomes |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
