Nutrition in Patients with Gastric Cancer: An Update

Abstract

Background: Nutritional management of patients with gastric cancer (GC) represents a challenge. Summary: This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease. Key Message: For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery. Early enteral nutrition after surgery improves early and long-term postoperative nutritional status and reduces the length of hospitalization as well. Vitamin B₁₂ and iron deficiency are common metabolic sequelae after gastrectomy and warrant appropriate replacement. In malnourished patients with advanced GC, short-term home complementary parenteral nutrition improves the quality of life, nutritional status and functional status. Total home parenteral nutrition represents the only modality of caloric intake for patients with advanced GC who are unable to take oral or enteral nutrition. Practical Implications: Early evaluations of nutritional status and nutritional support represent key aspects in the management of GC patients with both operable and advanced disease.

Nutritional assessment methods as predictors of postoperative mortality in gastric cancer patients submitted to gastrectomy

“…In a recent update of nutrition in patients with gastric cancer, PNI, or a combination of preoperative BMI<18.5kg/m 2 and low albumin levels, appear as predictors of decreased overall survival after gastrectomy 9 . In the present study we did not find statistical significance capable of proving the prediction of mortality.…”

“…Malnutrition, defined as a state of deficiency of energy, protein and other specific nutrients, has a negative impact on clinical outcome, with a longer hospital stay and increased mortality 7 . A thorough screening for malnutrition is very important, since preoperative nutritional interventions can restore nutritional status and improve surgical outcomes [8][9][10][11] .…”

Cáncer del tracto digestivo: asociación entre el estado nutricional y la capacidad funcional

“…Aunque el soporte nutricional contribuye a normalizar el estado nutricional, mejorar la funcionalidad y la calidad de vida, no debe olvidarse el enfoque terapéutico de aquellos pacientes que se encuentren en estadios tempranos y localmente avanzados con potencial curativo; en tanto, aquellos en estadios avanzados o metastásicos serán de control de síntomas, mejora de la calidad de vida y aumento en la supervivencia global [32][33][34] . Finalmente, es necesario que en nuestros centros contemos con herramientas de valoración nutricional que nos permitan la identificación oportuna de los pacientes en riesgo de desnutrición o con desnutrición; así mismo, de una escala de valoración del estado funcional y de calidad de vida, ya que resulta indispensable desde el punto de vista terapéutico de acuerdo con los objetivos del mismo.…”

Assessment of nutritional status in laparoscopic gastrectomy for gastric cancer

“…Gastric cancer is the fifth most common cancer and the third leading cause of cancer deaths worldwide (1). The incidence of malnutrition in gastric cancer patient is reported from 65% to 85% depending on the methods used to identify malnutrition (1,2).…”

“…The incidence of malnutrition in gastric cancer patient is reported from 65% to 85% depending on the methods used to identify malnutrition (1,2). Malnutrition tends to deteriorate during the hospitalization and may be exacerbated by treatment and disease itself (3,4).…”