Nutritional Support for Treatment Continuity and Survival in Advanced Gastric Cancer - A Propensity Score-matched Study

Q: What was the study’s main goal regarding nutritional support in advanced gastric cancer?

To clarify the effect of nutritional support on treatment continuity and survival in inpatients with advanced gastric cancer receiving first-line chemotherapy.

Q: Did nutritional support improve overall time to treatment failure, and which subgroup benefited most?

After propensity score matching, nutritional support was not associated with significant improvement in time to treatment failure in the overall population. The benefit was particularly evident in patients with hypoalbuminemia (albumin <3.5 g/dl).

Sep 23, 2026

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This retrospective propensity score-matched study clarifies the effect of nutritional support on treatment continuity and survival in inpatients with advanced gastric cancer receiving first-line chemotherapy. Medical records of consecutive unresectable or recurrent cases from 2007–2024 were reviewed, comparing patients who received individualized dietary counselling and multidisciplinary nutritional assessment with those who did not. Propensity score matching (1:1) adjusted baseline nutritional and inflammatory status; time to treatment failure served as the primary endpoint.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background/Aim

Patients and Methods

Results

Conclusion

Introduction

Patients and Methods

doi: 10.21873/invivo.14381 Nutritional Support for Treatment Continuity and Survival in Advanced Gastric Cancer: A Propensity Score-matched Study KEIJI SUGIYAMA1,2, TAKUMI ITO1, MASAHIRO YAGUCHI1, SEIRAOWAKI1, RIKU INO1, MARIKO SATO1, KAZUHIRO SHIRAISHI1, KYOKO KATO1, YOSHINORI IMAIZUMI3, NAO HINO3, MUTSUMI MURAYAMA4, MASAAKI SHIMADA4, YASUO UNO5, MASASHI HATTORI5, MASAYA SUENAGA5, YASUHIRO KODERA5, MITSURO KANDA2 and CHIYOE KITAGAWA1 1 Department of Medical Oncology, NHO Nagoya Medical Center, Aichi, Japan; 2 Department of Gastrointestinal Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan; 3 Department of Nutrition Service, NHO Nagoya Medical Center, Aichi, Japan; 4 Department of Gastroenterology, NHO Nagoya Medical Center, Aichi, Japan; 5 Department of Surgery, NHO Nagoya Medical Center, Aichi, Japan Abstract Background/Aim: This study aimed to clarify the effect of nutritional support inpatients with advanced gastric cancer (AGC) receiving first-line chemotherapy. Patients and Methods: We retrospectively reviewed the medical records of consecutive patients with unresectable or recurrent AGCtreated with first-line chemotherapy at Nagoya Medical Center between 2007 and 2024. Patients who received nutritional support were compared with those without nutritional support. Nutritional support included individualized dietary counselling, assessment of energy and protein requirements, and multidisciplinary evaluation. Propensity score matching (PSM, 1:1) was applied to adjust for baseline nutritional and inflammatory status. The primary endpoint was time to treatment failure (TTF). Subgroup analyses were conducted by baseline albumin level. Results: Among the 324 eligible patients included in the analysis, 76 received nutritional support. Before PSM, patients who were provided nutritional support more frequently presented with poor nutritional profiles. After PSM (n=46 per group), the median TTF was 5.0 months in patients without nutritional support and 4.6 months in those with it. Inpatients with hypoalbuminemia (albumin <3.5 g/dl), nutritional support significantly prolonged TTF. Finally, multivariate analysis in the pre-PSM cohort identified nutritional support as an independent predictor of TTF. Conclusion: Although nutritional support was not associated with significant TTF improvement in the overall AGC population after propensity score matching, it emerged asan independent predictor of treatment continuity in multivariate analysis of the pre-PSM cohort. This benefit was particularly evident in patients with hypoalbuminemia, indicating that targeted nutritional intervention is essential for this vulnerable subgroup to prevent premature treatment failure. Keywords: Advanced gastric cancer, nutritional support, propensity score matching, chemotherapy, hypoalbuminemia. ✉ Keiji Sugiyama, 4-1-1, Sannomaru, Nakaku, Nagoya, Aichi, Japan. Tel: +81 529511111, Fax: +81 9713334, e-mail: keiji. [sugi@gmail.com](sugi@gmail.com) Received March 23, 2026 | Revised April 20, 2026 | Accepted April 22, 2026 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. ©2026 The Author(s) . Published by the International Institute of Anticancer Research. Introduction Gastric cancer (GC) remains a major cause of cancer-related mortality worldwide (1) . For patients with advanced gastric cancer (AGC), systemic chemotherapy prolongs survival, but outcomes remain unsatisfactory, with median overall survival rarely exceeding 14-20 months (2-5). Cancer-associated malnutrition and cachexia are highly prevalent in AGC, affecting up to 80% of patients (6-9), and are linked to reduced treatment tolerance, impaired quality of life, and poor survival (10, 11). These conditions are driven by a complex interplay of systemic inflammation, metabolic dysregulation, and

FAQs

What was the study’s main goal regarding nutritional support in advanced gastric cancer?

To clarify the effect of nutritional support on treatment continuity and survival in inpatients with advanced gastric cancer receiving first-line chemotherapy.

How were patients grouped and what method was used to balance baseline differences?

Patients who received nutritional support were compared with those without. Propensity score matching (1:1) was applied to adjust baseline nutritional and inflammatory status.

Did nutritional support improve overall time to treatment failure, and which subgroup benefited most?

After propensity score matching, nutritional support was not associated with significant improvement in time to treatment failure in the overall population. The benefit was particularly evident in patients with hypoalbuminemia (albumin <3.5 g/dl).

What components constituted the nutritional support intervention?

Nutritional support included individualized dietary counselling, assessment of energy and protein requirements, and multidisciplinary evaluation.

Sep 23, 2026

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