title: Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy.
abstract: OBJECTIVE
  The aim of our study is firstly to evaluate the prevalence and prognostic value of nutrition risk in gastric cancer patients and secondly to explore whether the nutrition support can prolong the survival of advanced gastric cancer patients.
  
  
  METHODS
  It contained two study periods. In the first period, we prospectively evaluated the nutritional risk of gastric adenocarcinoma patients from 2009 to 2011 using the method of European Nutritional Risk Screening (NRS) 2002. The Kaplan-Meier method and log-rank test were used to evaluate the prognostic value of high nutrition risk. The second period was between 2012 and 2013. We prospectively gave the nutrition support to stage IV gastric cancer patients whose NRS is ≥3.
  
  
  RESULTS
  There were 830 patients in the first period, 50.7% patients with a NRS ≥ 3. Patients with NRS ≥ 3 presented a significantly higher percentage of stage IV diseases, elevated values of C-reactive protein, and hypoproteinemia. The median survival was significantly higher in NRS < 3 patients (31.9 vs. 25.7 months, P < 0.001). Multivariate analysis confirmed that NRS status was an independent prognostic factor. There were 347 patients in the second period. Young, male, and good response to chemotherapy were more likely to have the NRS shift to <3 after nutrition support. The median survival was 14.3 and 9.6 months for patients with and without NRS shift, respectively, P = 0.001.
  
  
  CONCLUSIONS
  NRS ≥ 3 was an independent adverse prognostic factor in gastric cancer patients. For stage IV patients whose NRS ≥ 3, the nutrition support might be helpful to improve the prognosis.
authors.affiliation: Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dong Feng Road East, Guangzhou, 510060, China.
authors.forename: Miaozhen
authors.initials: M
authors.lastname: Qiu
authors.forename: Yi-xin
authors.initials: YX
authors.lastname: Zhou
authors.forename: Yin
authors.initials: Y
authors.lastname: Jin
authors.forename: Zi-xian
authors.initials: ZX
authors.lastname: Wang
authors.forename: Xiao-li
authors.initials: XL
authors.lastname: Wei
authors.forename: Hong-yu
authors.initials: HY
authors.lastname: Han
authors.forename: Wen-feng
authors.initials: WF
authors.lastname: Ye
authors.forename: Zhi-wei
authors.initials: ZW
authors.lastname: Zhou
authors.forename: Dong-sheng
authors.initials: DS
authors.lastname: Zhang
authors.forename: Feng-hua
authors.initials: FH
authors.lastname: Wang
authors.forename: Yu-hong
authors.initials: YH
authors.lastname: Li
authors.forename: Da-jun
authors.initials: DJ
authors.lastname: Yang
authors.forename: Rui-hua
authors.initials: RH
authors.lastname: Xu
mesh_terms: D000230:Adenocarcinoma / Q000178:diet therapy* / Q000188:drug therapy* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007019:Hypoproteinemia / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000178:diet therapy* / Q000188:drug therapy* / Q000378:metabolism; D016019:Survival Analysis
chemical_list: D002097:C-Reactive Protein