{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:47:39Z","timestamp":1791902859626,"version":"4.3.4"},"reference-count":37,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_med-2026-1550_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Severe toxicity during adjuvant chemotherapy after curative gastrectomy is common. We evaluated whether postoperative malnutrition predicts severe toxicity, whether an inflammation-anemia (IA) composite adds incremental information, and whether a simple risk model offers clinical utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1550_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single-center prospective cohort, adults received adjuvant chemotherapy after curative gastrectomy. Malnutrition was defined as albumin &lt;35\u202fg\/L, BMI &lt;18.5\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , or low skeletal muscle index; IA as CRP\u00a0\u22651.5\u202fmg\/L plus hemoglobin &lt;120\u202fg\/L. A ridge-penalized logistic model included age, pathologic stage, regimen (S-1 vs. oxaliplatin-based multi-agent), malnutrition, IA, and a malnutrition\u00a0\u00d7\u00a0regimen interaction. Nested 5-fold cross-validation and decision curve analysis evaluated model performance and net benefit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1550_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 222 screened patients, 219 were analyzed. Severe toxicity occurred in 48\/219 (21.9\u202f%), more often with multi-agent therapy than S-1 (23.5 vs. 8.7\u202f%). Malnutrition was strongly associated with toxicity and remained an independent predictor (penalized OR 3.42, 95\u202f% CI 1.75\u20136.68), whereas IA was not. Out-of-sample AUROC was 0.695, Brier score 0.156, and calibration slope 0.86. At a 0.30 threshold, net benefit was higher for the full model than for base\u00a0+\u00a0malnutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1550_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Postoperative malnutrition is a key predictor of severe adjuvant chemotherapy toxicity after gastrectomy. This parsimonious model may support risk-adapted supportive care and treatment planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/med-2026-1550","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:00:57Z","timestamp":1791900057000},"source":"Crossref","is-referenced-by-count":0,"title":["Postoperative malnutrition predicts severe chemotherapy toxicity after gastrectomy: evaluation of an inflammation-anemia phenotype"],"prefix":"10.1515","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2015-4023","authenticated-orcid":false,"given":"Jiangtao","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of General Surgery , The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital) , Suzhou , Jiangsu , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6581-725X","authenticated-orcid":false,"given":"Zhengyu","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of General Surgery , The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital) , Suzhou , Jiangsu , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"2026101314005158518_j_med-2026-1550_ref_001","doi-asserted-by":"crossref","unstructured":"Kundel, Y, Purim, O, Idelevich, E, Lavrenkov, K, Man, S, Kovel, S, et al.. 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