Effects of Oral Nutritional Supplements in Gastric Cancer Patients with Malnutrition-Sarcopenia Syndrome

Malnutrition and sarcopenia may occur concurrently (Malnutrition-sarcopenia syndrome, MSS) in gastric cancer patients, affecting the prognosis and clinical outcomes. This study aimed to evaluate MSS prevalence and oral nutritional supplements (ONS) efficacy. This study included a retrospective analysis of 761 gastric cancer patients post-resection to assess MSS prevalence/prognosis, and a prospective non-randomized trial enrolled 81 MSS patients comparing ONS (500 kcal/day ×4 wk) versus standard care. In the retrospective cohort, MSS prevalence was 20.2%, and MSS independently predicted higher postoperative complication (OR: 2.330, 95% CI: 1.256-4.321, <i>p</i> = 0.007), recurrence/metastasis (OR: 4.162, 95% CI: 1.965-8.815, <i>p</i> < 0.001) and worse overall survival (HR: 1.649, 95% CI: 1.007-2.700, <i>p</i> = 0.047). In the prospective trial, ONS significantly improved weight maintenance compared to standard care (<i>p</i> = 0.032). Non-significant trends were observed in ONS group for shorter postoperative length of stay (PLOS) (6.8 vs 8.0 days), fewer complications (5.0% vs 22.0%) and improved handgrip strength (HGS) recovery (0.1 kg vs -0.9 kg). MSS is prevalent in gastric cancer and associated with adverse outcomes. ONS effectively preserves weight and shows recovery benefits, supporting its integration into MSS management.