Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2175-2182
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2175
Impact of nutritional support on immunity, nutrition, inflammation, and outcomes in elderly gastric cancer patients after surgery
Xiao-Wan Chen, Xiao-Chun Guo, Fen Cheng
Xiao-Wan Chen, Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Wuhan 430079, Hubei Province, China
Xiao-Chun Guo, Fen Cheng, Department of Gastroenterology, The First People’s Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
Co-first authors: Xiao-Wan Chen and Xiao-Chun Guo.
Author contributions: Chen XW and Guo XC contributed equally to this work, and they designed the research study; Cheng F and Chen XW performed the primary literature and data extraction; Guo XC analyzed the data and wrote the manuscript; Cheng Fen and Guo XC revised the manuscript for important intellectual content; and all authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Hubei Cancer Hospital (approval No. HB-C2023499).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Cfen987@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fen Cheng, BM BCh, Nurse, Department of Gastroenterology, The First People’s Hospital of Jiangxia District, No. 1 Wenhua Avenue, Jiangxia District, Wuhan 430200, Hubei Province, China. cfen987@163.com
Received: April 13, 2024
Revised: May 15, 2024
Accepted: May 30, 2024
Published online: July 27, 2024
Processing time: 99 Days and 24 Hours
Abstract
BACKGROUND

Postoperative rehabilitation of elderly patients with gastric cancer has always been the focus of clinical attention. Whether the intervention by a full-course nutritional support team can have a positive impact on the postoperative immune function, nutritional status, inflammatory response, and clinical outcomes of this special population has not yet been fully verified.

AIM

To evaluate the impact of full-course nutritional support on postoperative comprehensive symptoms in elderly patients with gastric cancer.

METHODS

This is a retrospective study, including 60 elderly gastric cancer patients aged 70 years and above, divided into a nutritional support group and a control group. The nutritional support group received full postoperative nutritional support, including individualized meal formulation, and intravenous and parenteral nutrition supplementation, and was regularly evaluated and adjusted by a professional nutrition team. The control group received routine postoperative care.

RESULTS

After intervention, the proportion of CD4+ lymphocytes (25.3% ± 3.1% vs 21.8% ± 2.9%, P < 0.05) and the level of immunoglobulin G (12.5 G/L ± 2.3 G/L vs 10.2 G/L ± 1.8 G/L, P < 0.01) were significantly higher in the nutritional support group than in the control group; the changes in body weight (-0.5 kg ± 0.8 kg vs -1.8 kg ± 0.9 kg, P < 0.05) and body mass index (-0.2 ± 0.3 vs -0.7 ± 0.4, P < 0.05) were less significant in the nutritional support group than in the control group; and the level of C-reactive protein (1.2 mg/L ± 0.4 mg/L vs 2.5 mg/L ± 0.6 mg/L, P < 0.01) and WBC count (7.2 × 109/L ± 1.5 × 109/L vs 9.8 × 109/L ± 2.0 × 109/L, P < 0.01) were significantly lower in the nutritional support group than in the control group. In addition, patients in the nutritional support group had a shorter hospital stay (10.3 d ± 2.1 d vs 14.8 d ± 3.6 d, P < 0.05) and lower incidence of infection (15% vs 35%, P < 0.05) in those of the control group.

CONCLUSION

The intervention by the nutritional support team has a positive impact on postoperative immune function, nutritional status, inflammatory response, and clinical outcomes in elderly patients with gastric cancer.

Keywords: Elderly gastric cancer; Postoperative; Nutritional support; Immune function; Inflammatory response; Clinical outcome

Core Tip: For elderly gastric cancer patients undergoing surgery, the provision of comprehensive and tailored nutritional support is crucial. Not only does it help maintain nutritional status and body weight, but it also significantly improves immune function and reduces inflammatory responses, leading to shorter hospital stays and lower complication rates. The individualized approach, regularly evaluated by a nutrition team, ensures that the nutritional plans are optimized for each patient’s specific needs.