ArticleBMC gastroenterology2025
Impact of PG-SGA-assessed malnutrition stratification on clinical outcomes in advanced gastrointestinal malignancies: a retrospective cohort study.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Preoperative Nutritional Risk Defines Treatment Tolerance and Guides Adjuvant Immunotherapy in Resectable Esophageal Squamous Cell Carcinoma.Annals of surgical oncology · 2026Article
- Combined Model of Inflammatory-Nutritional Indicators and Tumor Markers for Predicting Prognosis in Patients with Distal Cholangiocarcinoma: A Retrospective Cohort Study.Diseases (Basel, Switzerland) · 2026Article
- Association between pre-treatment malnutrition and chemotherapy toxicity in patients with advanced or metastatic gastroenteric tumors receiving systemic therapy.Frontiers in nutrition · 2026Article
- Combination of Naples prognostic score and pathological factors for evaluating the long-term prognosis of patients with late-onset colorectal cancer: a multicenter machine learning study.Translational cancer research · 2025Article
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Abstract
introductionThe traditional TNM staging system fails to explain survival heterogeneity in advanced gastrointestinal cancer, while malnutrition remains an underutilized prognostic modulator. We aimed to establish the prognostic value of dynamic nutritional risk stratification using the Patient-Generated Subjective Global Assessment (PG-SGA).
methodsIn this retrospective cohort study, 102 patients with AJCC 8th edition stage II-IV gastrointestinal malignancies underwent serial PG-SGA assessments at admission and 3-month follow-up. Nutritional risk was stratified as low-risk (PG-SGA 3-8) or high-risk (PG-SGA ≥ 9). Associations with overall survival (OS) were analyzed via Kaplan-Meier curves and multivariable Cox regression.
resultsAmong 102 advanced gastrointestinal malignancies patients, 68.63% (70/102) were high-risk nutritional group at admission versus 31.37% low-risk, with lower BMI in high-risk group (19.13 vs. 21.52 kg/m², P < 0.001) but comparable inflammatory/nutritional markers (P > 0.05). By 3 months, high-risk prevalence rose to 77.45% (79/102), where low-risk patients showed superior weight (58.00 vs. 50.00 kg), BMI (20.55 vs. 18.92 kg/m²), HB (120.13 vs. 100.91 g/L), ALB (41.15 vs. 34.33 g/L), PNI (47.12 vs. 39.72), CRP (1.63 vs. 11.54 mg/L), and dietary intake (all P < 0.05). Survival analysis confirmed 5-fold higher 3-year mortality risk in high-risk group (HR = 5.00, 95% CI: 2.00-12.47; P < 0.001). Multivariable analysis identified TNM stage IV (HR = 3.78, 95% CI: 1.25-11.42; P = 0.018), persistent high nutritional risk (HR = 4.09, 95% CI: 1.38-12.14; P = 0.011), and elevated CRP (HR = 2.32, 95% CI: 1.14-4.73; P = 0.020) as independent death predictors.
conclusionLongitudinal PG-SGA monitoring identifies critical nutritional deterioration threshold of PG-SGA ≥ 9 at 3-month follow-up and enables early intervention. We advocate integrating dynamic nutritional risk assessment into clinical frameworks to shift from empirical to predictive management in gastrointestinal oncology.
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