Precision-based tertiary care improves nutritional status and quality of life in patients undergoing adjuvant chemotherapy after radical gastrectomy for gastric cancer.

Objective: To assess the impact of a precision-based tertiary care protocol, including participatory dietary care, on the nutritional status, immune function, and quality of life in gastric cancer patients after radical gastrectomy.

Methods: The clinical and laboratory data of 124 patients diagnosed with gastric cancer at the Second People's Hospital of Lanzhou City from June 2020 to May 2022 were collected and retrospectively analyzed. The patients were grouped into a control group of 54 patients who received standard care and a study group of 70 patients who additionally received detailed tertiary care and bundled nutritional interventions. The clinical data (age, gender, surgical method, clinical staging, chemotherapy regimen, histories of diabetes, hypertension, smoking, alcohol consumption, time to first flatus and bowel movement, time to first liquid intake, length of hospital stay, complications at discharge, PG-SGA score, and QLQ-C30 score) and lab indices (serum albumin (ALB), prealbumin (PA), transferrin (TRF), hemoglobin (Hb), immunoglobulin A (IgA), M (IgM), and G (IgG)) were compared between the two groups.

Results: Study group had significantly higher levels of ALB, PA, TRF, Hb, IgA, IgM, and IgG compared to the control group after intervention (all P<0.001). QLQ-C30 score was higher while PG-SGA score was lower in the study group (both P<0.01). Postoperative digestive system recovery was faster in the study group, as evidenced by a shorter time to first anal defecation, bowel movement, liquid food intake, and hospital stay (P<0.001). Complication rate was significantly lower in the study group (P<0.05). Cox regression analysis showed age (P=0.021) and clinical stage (P=0.039) as independent prognostic factors, while treatment regimen was not (P>0.05).

Conclusion: Precision-based tertiary care protocol can improve nutritional status, enhance immune function, and facilitate faster postoperative recovery for gastric cancer patients following gastrectomy, thus greatly improving the quality of life of the patient. However, age and clinical staging, rather than the care protocol, are independent prognostic factors for patients' 1-year survival.