Global Leadership Initiative on Malnutrition criteria: Clinical benefits for patients with gastric cancer

Malnutrition is a prevalent condition among patients with gastric cancer and is associated with poor survival outcomes. This study aimed to evaluate the clinical utility of the Global Leadership Initiative on Malnutrition (GLIM) criteria in predicting survival among patients with gastric cancer. The multicenter retrospective cohort study (INSCOC study) included 1406 patients enrolled between December 2012 and April 2020, with follow-up data collected until June 2023. Various indices for muscle evaluation, such as calf circumference (CC) and body weight-standardized hand grip strength (HGS/W), were used to diagnose malnutrition. Kaplan-Meier curves were used to analyze the relationship between nutrition status, as defined by GLIM criteria, and survival outcomes in these patients. The analysis revealed that using CC or HGS/W as positive indicators of malnutrition effectively identified patients with survival-related malnutrition. The incidence of malnutrition was 54.5%, with patients' median overall survival times of 1169 days for stage I and 575 days for stage II cancer (P < 0.001). Malnutrition was identified as an independent risk factor for survival. Additionally, a nomogram developed through Cox regression analysis demonstrated precise predictive capability, incorporating factors such as tumor node metastasis staging, Karnofsky Performance Status Scale, direct bilirubin levels, and nutrition intervention. The study concludes that the GLIM criteria are effective in diagnosing malnutrition and predicting survival in patients with gastric cancer. Nutrition interventions significantly enhance survival outcomes, underscoring the importance of standardized nutrition treatments in improving patient prognosis.