| Objective: 1.Analyzed the nutritional status of all malignant tumor patients in our oncology department as of July 2021,and described the basic situation,case characteristics,dietary nutrition,and quality of life of hospitalized patients in our oncology department;2.Preoperative nutritional risk and prognostic factors of patients with advanced operable gastric cancer were analyzed.Methods: Prospective collection of patients diagnosed with malignant tumor in the Oncology Department of Yan ’an University Hospital in July 2021.General information included: patient’s gender,age,place of residence,education level,KPS score,primary malignant tumor type,malignant tumor stage,recurrence,metastasis,current treatment stage,etc.Nutritional Risk Screening Scale(NRS2002),Anorexia Cachexia Status Sub-Scale(FAACT-A/CS),concise diet Self-assessment form,EORTC Quality of Life Measurement Scale(QLQ-C30)and other investigation tools were used to conduct a cross-sectional study.Patients who received radical gastrectomy in the Affiliated Hospital of Yan ’an University from January 2013 to March 2019 were collected and analyzed.A total of 504 patients were included according to the inclusion and exclusion criteria.General information included: patient’s gender,age,BMI,scope of surgical resection,tumor size,tumor location,presence of vascular invasion,presence of nerve invasion,presence of cancer nodules,degree of differentiation,TNM staging(AJCC eighth edition TNM staging criteria);Clinical data included whether patients were treated with 4 to 6 cycles of standard chemotherapy after surgery,and preoperative nutritional risk assessment with NRS2002.This study mainly followed up whether the patients were built at death(time of death,cause of death),etc.The end points were death or the end of follow-up.The period from the date of surgery to the date of last follow-up or the patient’s death was determined as the overall survival time(OS),and March 31,2022 was set as the follow-up deadline.SPSS22.0 was used for statistical analysis,Chi-square test and Fisher’s exact probability method were used to evaluate the relationship between preoperative nutritional risk score and general and pathological data of patients with gastric cancer.Overall survival analysis method was adopted,Kaplan-Meier method was used for single factor analysis,and survival curves were drawn,and log-rank test was used to compare them.COX multiple regression method was used to analyze the significant factors.P<0.05(bilateral)was considered to have a significant difference.Results: 1.In July 2017,among the inpatients with malignant tumors in our hospital,digestive tract malignant tumors accounted for 29.4%,the largest number;Among them,gastric cancer patients ranked the third among the total inpatients,and gastrointestinal cancer patients ranked the first,accounting for 11.2% of the total number.Patients with malignant tumors had different degrees of dietary nutrition problems,and gastrointestinal malignancies showed the worst performance.The quality of life of hospitalized patients with malignant tumors was the worst in the symptom scale area.2.There were no statistically significant differences in preoperative nutritional risk incidence among groups in terms of gender,resection scope,tumor size,tumor site,vascular invasion,nerve invasion,cancer nodules,pathological classification,differentiation,CEA level,CA19-9 level,CA72-4 level,T stage,N stage,and TNM stage(P > 0.05).There were statistically significant differences in the incidence of preoperative nutritional risk among age groups and between groups with or without postoperative chemotherapy(P < 0.05).3.Univariate analysis was used to analyze factors that might be related to the overall survival time and 3-year survival rate of patients with gastric cancer.Age,tumor size,tumor nodule situation,tumor differentiation degree,preoperative CEA level,preoperative CA19-9 level,preoperative nutritional risk,T stage,N stage,TNM stage,postoperative chemotherapy and other factors had significant differences in survival(P <0.05).4.Degree of tumor differentiation,N stage,postoperative chemotherapy and preoperative CEA level were independent risk factors affecting the 3-year survival rate of patients with advanced operable gastric cancer(P < 0.05).Postoperative chemotherapy(RR: 0.619,95%CI interval: 0.460-0.832)was a protective factor for prognosis in patients with advanced operable gastric cancer.Differentiation degree(RR: 1.493,95%CI interval: 1.089-2.048),N stage(RR: 1.627,95%CI interval: 1.279-2.070),preoperative CEA level(RR: 1.777,95%CI interval:1.330-2.376)is a prognostic risk factor for patients with advanced operable gastric cancer.Conclusions:1.The number of hospitalized patients with gastrointestinal malignancies was the largest;Patients with malignant tumor have different degrees of dietary nutrition problems,digestive tract malignant tumor patients have more significant dietary nutrition problems than other primary types.The quality of life of hospitalized patients with malignant tumors was the worst in the symptom scale area.2.According to the NRS2002 nutritional risk assessment,52.8% of patients with advanced operable gastric cancer had nutritional risks before surgery,and there were statistically significant differences in the incidence of preoperative nutritional risks between age groups and between groups with or without postoperative chemotherapy.3.Age,tumor size,cancer nodule status,tumor differentiation degree,preoperative CEA level,preoperative CA19-9 level,preoperative nutritional risk,T stage,N stage,TNM stage,postoperative chemotherapy and other factors are related to the overall survival time and 3-year survival rate of patients with advanced operable gastric cancer.4.Degree of tumor differentiation,N stage,postoperative chemotherapy,and preoperative CEA level are independent risk factors affecting the overall survival time and 3-year survival rate of patients with advanced operable gastric cancer. |
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