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Immuno-Nutritional Profiling for Survival Stratification in Gastrectomized Patients with Malignant Chronic Intestinal
Konrad Matysiak1,2,3, Magdalena Szewczuk2,4, Aleksandra Hojdis2
1Centre for Intestinal Failure, Poznan University of Medical Sciences, 60-355 Poznań, Poland.
Nutrients
|February 13, 2026
Summary
For patients with gastric cancer requiring home parenteral nutrition (HPN) after gastrectomy, the Controlling Nutritional Status (CONUT) score and lymphocyte-to-monocyte ratio (LMR) predict survival. Combining CONUT and LMR improves risk stratification for these vulnerable patients.
Area of Science:
- Oncology
- Nutrition Science
- Immunology
Background:
- Patients undergoing gastrectomy for gastric cancer can develop chronic intestinal failure requiring home parenteral nutrition (HPN).
- This cohort faces significant risks from nutritional depletion and systemic inflammation, necessitating improved prognostic tools.
- Immuno-nutritional biomarkers offer potential for better risk stratification in this vulnerable population.
Purpose of the Study:
- To evaluate the prognostic value of the Controlling Nutritional Status (CONUT) score and the lymphocyte-to-monocyte ratio (LMR) in patients with gastric cancer requiring HPN.
- To assess the combined utility of CONUT and LMR for survival prediction in this patient group.
Main Methods:
- Retrospective analysis of 97 adult patients who underwent gastrectomy for gastric cancer and required HPN.
- Assessment of immuno-nutritional status using CONUT score and LMR at HPN qualification.
- Survival analysis using Cox proportional hazards models and receiver operating characteristic (ROC) analysis for LMR discrimination.
Main Results:
- Both CONUT score and LMR were independent predictors of overall survival.
- Each one-point increase in CONUT score was associated with a 70% increase in mortality risk.
- The combined CONUT-LMR model demonstrated superior prognostic classification compared to individual markers, with significant differences in AUC (p < 0.001).
Conclusions:
- CONUT score and LMR provide complementary prognostic information in patients with gastric cancer requiring HPN post-gastrectomy.
- Combined assessment of CONUT and LMR enhances survival stratification.
- These biomarkers may aid in the early identification of high-risk patients, guiding clinical management.
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