Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
Department of General Surgery, People's Hospital of Guyuan City, Ningxia, China.
Eur J Surg Oncol. 2023 May;49(5):964-973. doi: 10.1016/j.ejso.2023.01.009. Epub 2023 Jan 12.
The Global Leadership Initiative on Malnutrition released a new version of the malnutrition criteria (GLIM criteria). To investigate the influence of the GLIM criteria on the long-term efficacy of radical gastric cancer surgery and establish a nomogram to predict the long-term prognosis of patients with gastric cancer.
A retrospective analysis of 1121 patients with gastric cancer in our department from 2010 to 2013 was performed. A nomogram was established to predict overall survival (OS) based on the GLIM criteria. Patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the established nomogram.
Multivariate Cox regression analyses showed that GLIM criteria was an independent risk factor for the 5-year OS (HR = 1.768, Cl:1.341-2.329, p < 0.001). The C index, AUC and Time-ROC of the nomogram were significantly better than that of GLIM criteria and traditional criteria. The 5-year OS of patients receiving adjuvant chemotherapy in the high-risk group was significantly higher than that of patients without chemotherapy (45.77% vs. 24.73%,p < 0.001).
The GLIM criteria independently influence the long-term outcome of patients after radical gastric cancer surgery. The established nomogram can predict the long-term survival of patients with gastric cancer, and postoperative adjuvant chemotherapy for HRG can significantly improve the 5-year OS of patients.
全球营养不良领导倡议发布了营养不良标准的新版本(GLIM 标准)。为了研究 GLIM 标准对根治性胃癌手术长期疗效的影响,并建立一个列线图来预测胃癌患者的长期预后。
回顾性分析 2010 年至 2013 年我科收治的 1121 例胃癌患者。根据 GLIM 标准建立列线图预测总生存期(OS)。根据建立的列线图将患者分为低危组(LRG)和高危组(HRG)。
多因素 Cox 回归分析显示,GLIM 标准是 5 年 OS 的独立危险因素(HR=1.768,Cl:1.341-2.329,p<0.001)。列线图的 C 指数、AUC 和时间-ROC 明显优于 GLIM 标准和传统标准。高危组接受辅助化疗的患者 5 年 OS 明显高于未化疗的患者(45.77%比 24.73%,p<0.001)。
GLIM 标准独立影响根治性胃癌手术后患者的长期预后。建立的列线图可以预测胃癌患者的长期生存,术后对 HRG 进行辅助化疗可显著提高患者的 5 年 OS。