Perioperative Nutritional Treatment for Patients With Gastric Cancer: Focusing on Recent Controversial Issues

Despite the many advances in treatment methods for gastric cancer, it remains a leading cause of cancer-related mortality worldwide, with treatment outcomes intrinsically linked to the nutritional status of the patient. Malnutrition is a frequent and severe complication in patients with gastric cancer, arising from a confluence of factors including tumor-induced anorexia-cachexia syndrome, mechanical obstruction, and the metabolic stress of anti-cancer therapies including surgery and chemotherapy. Historically, nutritional support has often been a secondary consideration compared with surgical intervention or chemotherapy. However, a growing body of evidence has repositioned perioperative nutritional treatment as a cornerstone of comprehensive gastric cancer management. It is known that malnutrition can result in poorer clinical outcomes, including increased susceptibility to treatment-related toxicity, higher rates of postoperative complications, diminished quality of life, and a reduction in overall survival. Further, the paradigm shift toward proactive nutritional screening and assessment as standard clinical practice has allowed for timely and individualized prehabilitation. We conclude that advancements in nutritional science have fundamentally transformed gastric cancer management. The integration of tailored nutritional strategies throughout the journey of a patient from diagnosis through treatment and into survivorship is no longer just supportive, but a therapeutic modality in its own right. This symbiotic relationship emphasizes the necessity of a multidisciplinary approach, where oncologic and nutritional care are seamlessly interwoven to optimize patient outcomes and redefine the standards of gastric cancer treatment.