Background and aim:
Few studies have investigated the prognostic significance of nutritional indicators in patients with various inflammatory states.
Methods
Patients who underwent radical gastrectomy for TNM stages I–III gastric cancer were included. Nutritional assessment was performed using commonly used indicators. The patients were categorized into two groups with high and low inflammatory status using the X-tile analysis.
Results
A total of 1327 patients were enrolled in this study, including 843 and 484 patients in the low- and high-SII groups, respectively. Compared with the SII-low group, the SII-high group exhibited significantly lower GNRI, PNI, CXI, and SMI indices and a higher proportion of patients with malnutrition based on the GLIM and CONUT criteria(all P < 0.05). Multivariate COX analysis revealed that GLIM criteria (overall survival [OS]: P = 0.002; recurrence-free survival [RFS]: P = 0.007) and CONUT (OS: P = 0.010; RFS:P = 0.001) were independent prognostic factors for OS and RFS in the SII-low group. In the SII-high group, the GLIM criteria, GNRI, and SMI were the independent prognostic factors for OS(all P < 0.05), the GLIM criteria and SMI were the independent influencing factors for RFS(all P < 0.05). The TimeROC curve and AUC demonstrated the robustness of the GLIM criteria in predicting prognosis across various inflammatory states.
Conclusions
Different nutritional indicators should be considered while evaluating the prognosis of patients with gastric cancer with varying inflammatory states. Compared with other nutritional indicators, the GLIM criteria are more suitable for patients with different inflammatory conditions.