{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:02:45Z","timestamp":1792670565350,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The timing of nutritional assessment may be important to treat cancer patients and predict their prognosis. This study examined whether Patient-Generated Subjective Global Assessment (PG-SGA) and NUTRISCORE scores were associated with survival among gastric cancer patients who underwent surgery and chemotherapy and whether the timing of the assessment after surgery mattered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 952 gastric cancer patients (622 men and 330 women) were included in this retrospective cohort study. The PG-SGA and NUTRISCORE scores were calculated at 1 month (<jats:italic>n<\/jats:italic>\u2009=\u2009952), 2 months (<jats:italic>n<\/jats:italic>\u2009=\u2009657), and 3 months (<jats:italic>n<\/jats:italic>\u2009=\u2009294) after surgery. Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The PG-SGA scores assessed at 1 month after gastrectomy were not associated with survival. However, high PG-SGA scores at 2 months after gastrectomy (median\u2009=\u200965 days) were associated with an increased risk of mortality; the HR (95% CI) was 2.26 (1.22\u20134.21) for 9\u201311 vs. \u2264 5 of PG-SGA scores. When we included patients who received all three consecutive consultations, HR (95% CI) was 2.56 (1.02\u20136.42) for \u2265 9 (malnutrition) vs. \u2264 8 of PG-SGA scores assessed at 3 months after surgery (median days\u2009=\u200998 days). Likewise, high NUTRISCORE scores assessed at the 3-month follow-up were associated with higher mortality; the HR (95% CI) was 3.84 (1.18\u201312.55) for \u2265 7 vs. \u2264 4 of NUTRISCORE scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Malnutrition assessed with the PG-SGA and NUTRISCORE at 2 to 3 months after gastrectomy was associated with poor survival among gastric cancer patients. Our findings suggest that the timing of the nutritional evaluation may be important in identifying and treating malnutrition related to gastric cancer prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12876-022-02515-3","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T15:05:45Z","timestamp":1668697545000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Associations of patient-generated subjective global assessment (PG-SGA) and NUTRISCORE with survival in gastric cancer patients: timing matters, a retrospective cohort study"],"prefix":"10.1186","volume":"22","author":[{"given":"Jae Won","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyoung","family":"Youn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Mee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Gew","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Eun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"2515_CR1","unstructured":"International Agency for Research on Cancer. Globocan 2020: Incidence, mortality and prevalence by cancer site. 2022. https:\/\/gco.iarc.fr\/today\/data\/factsheets\/populations\/900-world-fact-sheets.pdf. Accessed 7 April 2022."},{"key":"2515_CR2","unstructured":"International Agency for Research on Cancer. Globocan 2020: Cancer incidence and mortality statistics worldwide and by region. 2021. https:\/\/gco.iarc.fr\/today\/data\/factsheets\/cancers\/7-Stomach-fact-sheet.pdf. Accessed 16 June 2021."},{"key":"2515_CR3","unstructured":"National Cancer Information Center. Incidence status by cancer type for Korea in 2019. 2022. https:\/\/www.cancer.go.kr\/lay1\/S1T639C641\/contents.do. Accessed 7 April 2022."},{"key":"2515_CR4","unstructured":"National Cancer Information Center. Mortality rate of major cancer for Korea in 2020. 2022. https:\/\/cancer.go.kr\/lay1\/S1T645C646\/contents.do. Accessed 7 April 2022."},{"issue":"7","key":"2515_CR5","doi-asserted-by":"publisher","first-page":"101042831771462","DOI":"10.1177\/1010428317714626","volume":"39","author":"Z Song","year":"2017","unstructured":"Song Z, Wu Y, Yang J, Yang D, Fang X. Progress in the treatment of advanced gastric cancer. Tumour Biol. 2017;39(7):1010428317714626.","journal-title":"Tumour Biol"},{"issue":"2","key":"2515_CR6","doi-asserted-by":"publisher","first-page":"79","DOI":"10.4174\/astr.2016.90.2.79","volume":"90","author":"HO Lee","year":"2016","unstructured":"Lee HO, Han SR, Choi SI, Lee JJ, Kim SH, Ahn HS, et al. Effects of intensive nutrition education on nutritional status and quality of life among postgastrectomy patients. Ann Surg Treat Res. 2016;90(2):79\u201388.","journal-title":"Ann Surg Treat Res"},{"issue":"3","key":"2515_CR7","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1007\/s10147-017-1089-y","volume":"22","author":"T Aoyama","year":"2017","unstructured":"Aoyama T, Sato T, Maezawa Y, Kano K, Hayashi T, Yamada T, et al. Postoperative weight loss leads to poor survival through poor S-1 efficacy in patients with stage II\/III gastric cancer. Int J Clin Oncol. 2017;22(3):476\u201383.","journal-title":"Int J Clin Oncol"},{"issue":"4","key":"2515_CR8","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/S0959-8049(97)10090-9","volume":"34","author":"HJ Andreyev","year":"1998","unstructured":"Andreyev HJ, Norman AR, Oates J, Cunningham D. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998;34(4):503\u20139.","journal-title":"Eur J Cancer"},{"issue":"3","key":"2515_CR9","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.clnu.2007.01.005","volume":"26","author":"MM Marin Caro","year":"2007","unstructured":"Marin Caro MM, Laviano A, Pichard C. Nutritional intervention and quality of life in adult oncology patients. Clin Nutr. 2007;26(3):289\u2013301.","journal-title":"Clin Nutr"},{"issue":"5","key":"2515_CR10","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1097\/MCO.0000000000000389","volume":"20","author":"H Jager-Wittenaar","year":"2017","unstructured":"Jager-Wittenaar H, Ottery FD. Assessing nutritional status in cancer: role of the Patient-Generated Subjective Global Assessment. Curr Opin Clin Nutr Metab Care. 2017;20(5):322\u20139.","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2515_CR11","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.nut.2016.07.015","volume":"33","author":"L Arribas","year":"2017","unstructured":"Arribas L, Hurtos L, Sendros MJ, Peiro I, Salleras N, Fort E, et al. NUTRISCORE: A new nutritional screening tool for oncological outpatients. Nutrition. 2017;33:297\u2013303.","journal-title":"Nutrition"},{"issue":"11\u201312","key":"2515_CR12","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1016\/j.nut.2015.06.001","volume":"31","author":"CS Rodrigues","year":"2015","unstructured":"Rodrigues CS, Lacerda MS, Chaves GV. Patient Generated Subjective Global Assessment as a prognosis tool in women with gynecologic cancer. Nutrition. 2015;31(11\u201312):1372\u20138.","journal-title":"Nutrition"},{"key":"2515_CR13","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.nut.2016.06.009","volume":"36","author":"HS Kim","year":"2017","unstructured":"Kim HS, Lee JY, Lim SH, Cho J, Kim SJ, Jang JH, et al. Patient-Generated Subjective Global Assessment as a prognosis tool in patients with multiple myeloma. Nutrition. 2017;36:67\u201371.","journal-title":"Nutrition"},{"key":"2515_CR14","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.2147\/CMAR.S193567","volume":"11","author":"T Ge","year":"2019","unstructured":"Ge T, Lin T, Yang J, Wang M. Nutritional status and related factors of patients with advanced lung cancer in northern China: a retrospective study. Cancer Manag Res. 2019;11:2225\u201331.","journal-title":"Cancer Manag Res"},{"key":"2515_CR15","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.nut.2018.05.021","volume":"57","author":"E Alvaro Sanz","year":"2019","unstructured":"Alvaro Sanz E, Garrido Siles M, Rey Fernandez L, Villatoro Roldan R, Rueda Dominguez A, Abiles J. Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: Early intervention protocol. Nutrition. 2019;57:148\u201353.","journal-title":"Nutrition"},{"issue":"1","key":"2515_CR16","doi-asserted-by":"publisher","first-page":"21186","DOI":"10.1038\/s41598-020-78246-w","volume":"10","author":"E \u00c1lvaro Sanz","year":"2020","unstructured":"\u00c1lvaro Sanz E, Abil\u00e9s J, Garrido Siles M, Rivas Ru\u00edz F, Tortajada Goitia B, Dom\u00ednguez AR. Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy. Sci Rep. 2020;10(1):21186.","journal-title":"Sci Rep"},{"issue":"4","key":"2515_CR17","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1245\/s10434-018-6342-8","volume":"25","author":"K Fujiya","year":"2018","unstructured":"Fujiya K, Kawamura T, Omae K, Makuuchi R, Irino T, Tokunaga M, et al. Impact of Malnutrition After Gastrectomy for Gastric Cancer on Long-Term Survival. Ann Surg Oncol. 2018;25(4):974\u201383.","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"2515_CR18","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/j.clnu.2018.02.015","volume":"38","author":"SE Oh","year":"2019","unstructured":"Oh SE, Choi MG, Seo JM, An JY, Lee JH, Sohn TS, et al. Prognostic significance of perioperative nutritional parameters in patients with gastric cancer. Clin Nutr. 2019;38(2):870\u20136.","journal-title":"Clin Nutr"},{"key":"2515_CR19","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-40618-3","volume-title":"AJCC Cancer Staging Manual","author":"MB Amin","year":"2017","unstructured":"Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, et al. AJCC Cancer Staging Manual. 8th ed. New York (NY): Springer; 2017.","edition":"8"},{"issue":"1 Suppl","key":"2515_CR20","first-page":"15-9","volume":"12","author":"FD Ottery","year":"1996","unstructured":"Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition. 1996;12(1 Suppl):15-9.","journal-title":"Nutrition"},{"key":"2515_CR21","volume-title":"Clinical Nutrition for Oncology Patients","author":"P Charney","year":"2010","unstructured":"Charney P, Cranganu A. Clinical Nutrition for Oncology Patients. Sudbury: Jones and Bartlett Publishers; 2010."},{"issue":"3","key":"2515_CR22","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.nut.2009.04.013","volume":"26","author":"GA Wie","year":"2010","unstructured":"Wie GA, Cho YA, Kim SY, Kim SM, Bae JM, Joung H. Prevalence and risk factors of malnutrition among cancer patients according to tumor location and stage in the National Cancer Center in Korea. Nutrition. 2010;26(3):263\u20138.","journal-title":"Nutrition"},{"key":"2515_CR23","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","volume":"34","author":"DR Cox","year":"1972","unstructured":"Cox DR. Regression models and life-tables. J R Stat Soc Series B. 1972;34:187\u2013220.","journal-title":"J R Stat Soc Series B"},{"key":"2515_CR24","first-page":"74","volume-title":"Oncology Nutrition for Clinical Practice","author":"KK Hamilton","year":"2021","unstructured":"Hamilton KK. Nutritional needs of the adult oncology patient. In: Voss AC, Williams V, editors. Oncology Nutrition for Clinical Practice. 2nd ed. Chicago: Academy of Nutrition and Dietetic; 2021. pp.74\u201387.","edition":"2"},{"key":"2515_CR25","unstructured":"Elliott L. Symptom management of cancer therapies. In: Anne Coble Voss, Valaree Williams. Oncology nutrition for clinical practice. In: Voss AC, Williams V, editors. Oncology Nutrition for Clinical Practice. 2nd ed. Chicago, IL: Academy of Nutrition and Dietetic; 2021. p.115 \u2013 22."},{"issue":"1","key":"2515_CR26","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s10620-015-3839-x","volume":"61","author":"P Berg","year":"2016","unstructured":"Berg P, McCallum R. Dumping Syndrome: A Review of the Current Concepts of Pathophysiology, Diagnosis, and Treatment. Dig Dis Sci. 2016;61(1):11\u20138.","journal-title":"Dig Dis Sci"},{"issue":"3","key":"2515_CR27","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1159\/000477779","volume":"35","author":"BW Eom","year":"2018","unstructured":"Eom BW, Kim J, Kim DH, Kim YI, Yoon HM, Cho SJ, et al. Recovery of Food Intake after Gastrectomy for Gastric Cancer: Based on a Large-Scale Gastric Cancer Cohort. Dig Surg. 2018;35(3):220\u20139.","journal-title":"Dig Surg"},{"issue":"2","key":"2515_CR28","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.jand.2016.05.010","volume":"117","author":"KL Thompson","year":"2017","unstructured":"Thompson KL, Elliott L, Fuchs-Tarlovsky V, Levin RM, Voss AC, Piemonte T. Oncology Evidence-Based Nutrition Practice Guideline for Adults. J Acad Nutr Diet. 2017;117(2):297\u2013310.e47.","journal-title":"J Acad Nutr Diet"},{"issue":"4","key":"2515_CR29","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.ejon.2015.01.008","volume":"19","author":"V Sun","year":"2015","unstructured":"Sun V, Kim J, Kim JY, Raz DJ, Merchant S, Chao J, et al. Dietary alterations and restrictions following surgery for upper gastrointestinal cancers: Key components of a health-related quality of life intervention. Eur J Oncol Nurs. 2015;19(4):343\u20138.","journal-title":"Eur J Oncol Nurs"},{"issue":"17","key":"2515_CR30","doi-asserted-by":"publisher","first-page":"e3504","DOI":"10.1097\/MD.0000000000003504","volume":"95","author":"MC Hsieh","year":"2016","unstructured":"Hsieh MC, Wang SH, Chuah SK, Lin YH, Lan J, Rau KM. A Prognostic Model Using Inflammation- and Nutrition-Based Scores in Patients With Metastatic Gastric Adenocarcinoma Treated With Chemotherapy. Med (Baltim). 2016;95(17):e3504.","journal-title":"Med (Baltim)"},{"issue":"5","key":"2515_CR31","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1177\/0884533617725071","volume":"32","author":"EVM Wiegert","year":"2017","unstructured":"Wiegert EVM, Padilha PC, Peres WAF. Performance of Patient-Generated Subjective Global Assessment (PG-SGA) in Patients With Advanced Cancer in Palliative Care. Nutr Clin Pract. 2017;32(5):675\u201381.","journal-title":"Nutr Clin Pract"},{"issue":"3","key":"2515_CR32","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1002\/jpen.2199","volume":"46","author":"IM de Sousa","year":"2022","unstructured":"de Sousa IM, Silva FM, de Carvalho ALM, da Rocha IMG, Fayh APT. Accuracy of isolated nutrition indicators in diagnosing malnutrition and their prognostic value to predict death in patients with gastric and colorectal cancer: A prospective study. JPEN J Parenter Enteral Nutr. 2022;46(3):508\u201316.","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"2515_CR33","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-021-01021-1","author":"M Gascon-Ruiz","year":"2021","unstructured":"Gascon-Ruiz M, Casas-Deza D, Torres-Ramon I, Zapata-Garcia M, Alonso N, Sesma A, et al. Comparation of different malnutrition screening tools according to GLIM criteria in cancer outpatients. Eur J Clin Nutr. 2021. doi:https:\/\/doi.org\/10.1038\/s41430-021-01021-1.","journal-title":"Eur J Clin Nutr"},{"issue":"5","key":"2515_CR34","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1097\/SLA.0000000000001445","volume":"262","author":"HM Heneghan","year":"2015","unstructured":"Heneghan HM, Zaborowski A, Fanning M, McHugh A, Doyle S, Moore J, et al. Prospective Study of Malabsorption and Malnutrition After Esophageal and Gastric Cancer Surgery. Ann Surg. 2015;262(5):803\u20137. discussion 807-8.","journal-title":"Ann Surg"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02515-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-022-02515-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02515-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T23:59:33Z","timestamp":1728431973000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-022-02515-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,17]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["2515"],"URL":"https:\/\/doi.org\/10.1186\/s12876-022-02515-3","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,17]]},"assertion":[{"value":"29 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the institutional review board of Samsung Medical Center. Also the institutional review board of Samsung Medical Center waived the need for informed consent. All the authors confirm that all methods were carried out in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no conflict of interest associated with this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"468"}}