Impact of oral nutritional supplements on nutritional outcomes and survival in post-gastrectomy patients receiving chemotherapy.

BACKGROUND & AIMS: Malnutrition complicates recovery in gastrectomy patients, worsened by adjuvant chemotherapy and linked to poorer outcomes. However, evidence regarding the influence of Oral Nutritional Supplements (ONS) on skeletal muscle index (SMI), chemotherapy tolerance, and long-term survival remains limited. This investigation sought to assess therapeutic effects associated with ONS among post-gastrectomy patients receiving adjuvant chemotherapy.

METHODS

This research represents a secondary analysis based on a randomized controlled trial (RCT), focusing on long-term follow-up of gastric cancer patients undergoing surgery followed by adjuvant chemotherapy. Patients at nutritional risk, defined by a Nutritional Risk Screening 2002 (NRS2002) score of ≥3, were randomized to standard nutritional guidance (Control) or guidance plus 500 ml/day of ONS (Intervention) for three months. Primary outcomes included nutritional parameters (weight, body mass index [BMI], SMI), as well as overall survival. Secondary outcomes included chemotherapy tolerance and readmissions within 90 days.

RESULTS

Analyses included 229 patients (Control: n = 112; Intervention: n = 117). Following the three-month period, body weight reduction was attenuated with ONS relative to standard care (2.51 kg vs. 3.98 kg, P < 0.001), with BMI preserved at higher levels (20.02 kg/m2 vs. 19.22 kg/m2). SMI did not differ significantly. Chemotherapy adherence was markedly better in the ONS cohort (76.1% vs. 58.9%), while readmissions within 90 days and overall survival remained comparable.

CONCLUSIONS

Postoperative ONS intervention improved weight maintenance and chemotherapy tolerance but did not prevent muscle depletion or improve survival in gastric cancer patients undergoing adjuvant chemotherapy. ONS may represent a valuable early supportive measure; longer-duration, higher-intensity or multimodal approaches may be required to enhance muscle preservation and long-term prognosis.