With this study, we aimed to present the impact of malnutrition on the tolerability and efficacy ofchemotheraphy, and overall survival on metastatic gastric cancer (mGC) patients.
In this prospective multicenter study, we collected demographic, oncological and nutritional data for our mGC patients. Nutritional status was assessed with the Nutritional Risk Index (NRI), Body Mass Index (BMI) and clinical weight loss percentage with 21-day period during two chemotherapy cycles. NRI were calculated with formula as following; 1.519 x serum albumin level (g/L) + 41.7 x current weight/basic weight. Patients were calssified as having ‘no’ (NRI >97.5), ‘moderate’ (97.5 ≥ NRI ≥83.5) or ‘severe’ (NRI <83.5) malnutrition. Drug-induced toxicities were evaluated using National Cancer Institute CTCAE version 4.0 and treatment responses were evaluated using RECIST Criteria 1.1.
116 mGC patients enrolled. Median age was 60 years. Primary location of tumor was non-antrum/antrum with 60/40% and 24% of patients had experienced primary tumor resection. WHO performance status of patients was 0-1 for 98%. All treatments were first-line setting. 41% of patients dead of during follow up period (Median: 138 days, Range: 21-378). Malnurition diagnosed in 68 % of the patients and was severe in 32%. Moderate/severe malnutrution was associated with more treatment toxicity (≥ grade 2 cytopenia, nausea/vomiting, diarrhea, neuropathy; p < 0.05 for all parameters). Moderate/severe malnutrution was not associated with chemoteraphy responses (p = 0.215). Malnutritional level was associated with significantly reduced overall survival (OS), none, moderately or severe malnourished groups, with 350 days (95% CI, 176.0 - 524.0), 210 (95 %CI, 166.3 - 253.7), 74 (95% CI, 20.7 - 111.0) respectively (p = 0.025). Severe malnutition was associated with shorter OS (74 vs. 237 days in non/moderatery, p = 0.007).
In mGC patients, moderate/severe malnutrition is associated with worse non-hematological chemotherapy toxicities. Malnutrition level and severe malnutrition is also associated reduced overall survival.
Clinical trial identification
Legal entity responsible for the study
Has not received any funding.
All authors have declared no conflicts of interest.