European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Impact of nutrition, comorbidity and complication on long term survival in gastric cancer following laparoscopic radical gastrectomy: A 10-year cohort study.
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Zhang Hengyi, Tao Siqi, Luo Yangyang, Lu Mengting, Li Guoxin, Liu Hao
Аннотация
BACKGROUND: Previous studies on perioperative influences in gastric cancer have largely relied on single scoring systems, overlooking the interaction between factors. This study utilized the Age-Adjusted Charlson Comorbidity Index (ACCI), Nutritional Risk Screening-2002 (NRS-2002), and Clavien-Dindo classification to assess the impact of key perioperative conditions on long-term survival in a large-scale cohort of gastric cancer patients.
METHOD: This study analyzed 2420 gastric cancer patients who underwent laparoscopic radical resection between January 2004 and December 2023 at Nanfang Hospital, Southern Medical University, Guangzhou, China. The analysis, based on postoperative complications, comorbidity burden, and nutritional status, was conducted using Clavien-Dindo classification, ACCI, and NRS-2002, and compared their impact on long-term survival.
RESULT: Patients with a low comorbidity burden have significantly higher survival rates compared to those with a high comorbidity burden (5-year: 72.5 %, 10-year: 64.4 %). Patients with better nutritional status also have higher survival rates than those with malnutrition (5-year: 72.6 %, 10-year: 65.0 %). However, postoperative complications do not significantly affect overall survival trends (P = 0.14). Among patients with the same ACCI score, those with malnutrition have significantly lower survival rates (5-year: 44.8 %, 10-year: 31.1 %). Furthermore, among patients with the same nutritional status, those with postoperative complications have markedly worse survival outcomes (5-year: 49.8 %, 10-year: 32.2 %).
CONCLUSION: A more precise assessment of the perioperative condition in gastric cancer patients would be recommended via integrating nutritional status with comorbidities or postoperative complications. Improving these conditions are expecting to enhance the long-term overall survival postoperatively.
METHOD: This study analyzed 2420 gastric cancer patients who underwent laparoscopic radical resection between January 2004 and December 2023 at Nanfang Hospital, Southern Medical University, Guangzhou, China. The analysis, based on postoperative complications, comorbidity burden, and nutritional status, was conducted using Clavien-Dindo classification, ACCI, and NRS-2002, and compared their impact on long-term survival.
RESULT: Patients with a low comorbidity burden have significantly higher survival rates compared to those with a high comorbidity burden (5-year: 72.5 %, 10-year: 64.4 %). Patients with better nutritional status also have higher survival rates than those with malnutrition (5-year: 72.6 %, 10-year: 65.0 %). However, postoperative complications do not significantly affect overall survival trends (P = 0.14). Among patients with the same ACCI score, those with malnutrition have significantly lower survival rates (5-year: 44.8 %, 10-year: 31.1 %). Furthermore, among patients with the same nutritional status, those with postoperative complications have markedly worse survival outcomes (5-year: 49.8 %, 10-year: 32.2 %).
CONCLUSION: A more precise assessment of the perioperative condition in gastric cancer patients would be recommended via integrating nutritional status with comorbidities or postoperative complications. Improving these conditions are expecting to enhance the long-term overall survival postoperatively.