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| Prognostic value of the Global Leadership Initiative on Malnutrition GLIM -defined malnutrition for gastric cancer patients |
| Xu Tingting, Wang Chenchen ,Lu Yingying ,Zhang Yan |
| Department of Medical Oncology Hai'an Hospital Affiliated to Nantong University Hai'an 226600 Jiangsu China |
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Abstract The purpose of this study was to investigate the clinical value of Global Leadership Initiative on
Malnutrition GLIM criteria and evaluate the relationship between GLIM-defined malnutrition and survival outcome of gastric cancer
patients. Method Totally 174 gastric cancer patients who underwent radical resection at the Department of Gastrointestinal Surgery in
our hospital from January 2017 to December 2021were selected as the research participants. Body mass index BMI and the third
lumbar skeletal muscle index SMI were used as phenotypic criteria of GLIM consensus for the evaluation of nutritional status and the
diagnosis of malnutrition. The effects of GLIM-defined malnutrition on the prognosis of gastric cancer patients were estimated by KaplanMeier method and the univariate and multivariate Cox regression analysis. Result Nutritional risk screening at admission showed that
80 46. 0% of 174 gastric cancer patients were at risk of malnutrition NRS 2002 ≥3 . According to the GLIM criteria it was found
that 57 32. 8% of 174 gastric cancer patients were diagnosed with malnutrition before surgery and low BMI was observed in
24 13. 8% patients and reduced muscle mass was observed in 51 29. 3% patients. BMI 20. 4 ± 2. 5 vs 23. 5 ± 3. 4 kg / m
2
t = 6. 093 P<0. 001 SMI 37. 9 ± 4. 2 vs 46. 2 ± 7. 9 cm
2
/ m
2
t = 7. 424 P<0. 001 hemoglobin concentration 125. 0 ±
18. 0 vs 136. 0 ± 20. 0 g / L t = 3. 333 P= 0. 001 and serum albumin level 36. 7 ± 4. 6 vs 39. 0 ± 3. 9 g / L t = 2. 470
P= 0. 014 were significantly lower in patients with GLIM-defined malnutrition than in those without malnutrition. Survival analysis
indicated that the 5-year disease-free survival DFS rates of patients with and without malnutrition based on the GLIM criteria were
49. 8% and 75. 6% respectively
χ
2 = 7. 502 P = 0. 006 . Subgroup analysis showed that GLIM - defined malnutrition was
significantly associated with worse DFS of stage Ⅲ patients. The 5 -year DFS rates of patients with and without malnutrition were
31. 7% and 69. 2% with a significantly statistical difference
χ
2 = 12. 523 P<0. 001 . In addition the univariate and multivariate
Cox regression analysis demonstrated that GLIM - defined malnutrition HR = 2. 180 95% CI = 1. 288 - 3. 687 P = 0. 004 TNM stage HR = 2. 216 95% CI = 1. 245 - 3. 947 P = 0. 007 and Borrmann classification HR = 2. 171 95% CI = 1. 019 - 4. 624 P =
0. 044 were independent prognostic factors for gastric cancer patients. Conclusion GLIM criteria could reflect the nutritional status of
gastric cancer patients and it could be used as an effective tool for prognostic assessment.
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