ArticleOpen medicine (Warsaw, Poland)2026
Postoperative malnutrition predicts severe chemotherapy toxicity after gastrectomy: evaluation of an inflammation-anemia phenotype.
Article in Open medicine (Warsaw, Poland), 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
Objectives: Severe toxicity during adjuvant chemotherapy after curative gastrectomy is common. We evaluated whether postoperative malnutrition predicts severe toxicity, whether an inflammation-anemia (IA) composite adds incremental information, and whether a simple risk model offers clinical utility. Methods: In this single-center prospective cohort, adults received adjuvant chemotherapy after curative gastrectomy. Malnutrition was defined as albumin <35 g/L, BMI <18.5 kg/m Results: Of 222 screened patients, 219 were analyzed. Severe toxicity occurred in 48/219 (21.9 %), more often with multi-agent therapy than S-1 (23.5 vs. 8.7 %). Malnutrition was strongly associated with toxicity and remained an independent predictor (penalized OR 3.42, 95 % CI 1.75-6.68), whereas IA was not. Out-of-sample AUROC was 0.695, Brier score 0.156, and calibration slope 0.86. At a 0.30 threshold, net benefit was higher for the full model than for base + malnutrition. Conclusions: Postoperative malnutrition is a key predictor of severe adjuvant chemotherapy toxicity after gastrectomy. This parsimonious model may support risk-adapted supportive care and treatment planning.
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