Relationship Between GLIM-Defined Malnutrition and Postoperative Outcomes After Curative Resection in Patients With...

Area of Science:

• Oncology
• Gastroenterology
• Nutritional Science

Background:

• Malnutrition negatively impacts cancer patient outcomes, increasing complications and reducing prognosis.
• The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a standardized definition for malnutrition.

Purpose of the Study:

• To update the understanding of malnutrition's impact on postoperative outcomes in gastrointestinal cancer patients.
• To assess the effect of GLIM-defined malnutrition on overall survival and postoperative complications after curative resection.

Main Methods:

• Systematic review and random-effects meta-analysis of observational studies.
• Included adult patients (age > 18 years) with gastrointestinal cancer undergoing surgery and assessed for GLIM criteria.
• Primary outcomes: overall survival (OS) and overall postoperative complications (Clavien-Dindo grade ≥ II within 30 days).

Main Results:

• Twenty-five studies (10,942 patients) were analyzed.
• GLIM-defined malnutrition was associated with a probable worsening of OS (HR: 1.88; CI: 1.62-2.18).
• Malnutrition significantly increased postoperative complications (RRR: 1.57; CI: 1.34-1.84), with low certainty of evidence.

Conclusions:

• GLIM-defined malnutrition is likely detrimental to overall survival in gastrointestinal cancer patients post-surgery.
• Malnutrition increases the risk of postoperative complications, highlighting the need for nutritional assessment and intervention.