Effect of whole-course nutrition management on skeletal muscle mass in patients with gastric cancer undergoing neoadjuvant treatment.

[BACKGROUND] The role of nutritional management and skeletal muscle mass assessment in the treatment of gastric cancer has received increasing attention. This study aims to investigate the effect of whole-course nutrition management on postoperative skeletal muscle mass, incidence of complications, readmission rate and overall survival in patients with gastric cancer undergoing neoadjuvant treatment.

[METHODS] Patients with gastric cancer who underwent radical gastrectomy after neoadjuvant treatment from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into whole-course nutrition management group and control group. Clinical data including demographic information, duration of neoadjuvant chemotherapy regimen, radiotherapy or not, nutritional assessment, nutritional intervention, surgery, and pathology were collected. The primary outcome was skeletal muscle mass measured by computed tomography at 6 months after surgery compared with that before neoadjuvant treatment, which was the cross-sectional area of the third lumbar spine measured by ImageJ software.

[RESULTS] Among 182 initially enrolled patients, propensity score matching yielded 110 patients in the whole-course nutrition management group and 57 in the control group. A statistically significant difference was observed in skeletal muscle area change between the two groups (P = 0.045). However, no significant differences were found in in-hospital complication rates, 90-day readmission rates, overall survival, or disease-free survival.

[CONCLUSIONS] In patients with gastric cancer undergoing neoadjuvant treatment, whole-course nutrition management can significantly improve the loss of skeletal muscle mass. Nevertheless, this improvement did not translate into a significant reduction in in-hospital complication rates, readmission rates, or improved survival outcomes.