ArticleFrontiers in nutrition2026
Association between postoperative nutritional status and time to initiation of adjuvant chemotherapy in gastrointestinal cancers: a restricted cubic spline analysis.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To explore the relationship between early postoperative nutritional status and time-to-chemotherapy (TTC) in gastrointestinal cancer patients and provide a reference for nutritional intervention and reasonable chemotherapy arrangements. Methods: This study enrolled consecutive patients who underwent radical gastrointestinal cancer surgery with planned adjuvant chemotherapy at a tertiary hospital in Dalian, China (June 2023-June 2025). Nutritional indicators included BMI, NRS-2002 score, and serum albumin concentration and their associations with TTC were analyzed using restricted cubic splines (RCS) and multivariable regression models. Results: RCS analysis revealed an approximately linear dose-response relationship between the NRS-2002 score and TTC. Based on multivariate regression, each 1-point increase prolonged TTC by 2.36 days and conferred a 57% higher risk of chemotherapy delay. Conversely, BMI and serum ALB levels exhibited nonlinear associations with TTC (U-shaped and inverted L-shaped, respectively). Exploratory inflection points derived from RCS were BMI ≥ 23.82 kg/m Conclusion: Postoperative nutritional indicators are closely related to TTC. The inflection point values of BMI and serum albumin derived from this study are hypothesis-generating findings and should not be regarded as validated clinical targets for routine clinical application. Targeted nutritional management may help optimize chemotherapy timing and guide clinical nursing work.
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