{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:56:14Z","timestamp":1787165774077,"version":"build-2736575974"},"reference-count":48,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Patients who undergo gastrectomy for gastric adenocarcinoma and subsequently develop chronic intestinal failure requiring long-term home parenteral nutrition (HPN) represent a clinically vulnerable cohort in whom survival is shaped by profound nutritional depletion and systemic inflammation. Immuno-nutritional biomarkers may support improved risk stratification in this setting. Methods: This retrospective study included adults who underwent gastrectomy for gastric cancer and developed malignant chronic intestinal failure requiring HPN. Immuno-nutritional status at HPN qualification was evaluated using the Controlling Nutritional Status (CONUT) score and the lymphocyte-to-monocyte ratio (LMR). Overall survival was analysed using Cox proportional hazards models. LMR discrimination was assessed using receiver operating characteristic (ROC) analysis with a Youden-derived cut-off, and differences in AUC were tested using DeLong\u2019s method. Results: Ninety-seven patients met the inclusion criteria. Median overall survival was 176 days. In multivariable analysis, CONUT and LMR were the only independent predictors of survival. Each one-point increase in CONUT was associated with an approximately 70% increase in mortality risk. LMR demonstrated good discriminative ability (AUC 0.795), and a cut-off of 2.083 differentiated survival trajectories. The combined CONUT\u2013LMR model improved prognostic classification, and DeLong\u2019s test confirmed a significant AUC difference compared with single-marker models. Kaplan\u2013Meier curves showed clear separation across CONUT and LMR strata (log-rank p &lt; 0.001). Conclusions: Among patients requiring long-term HPN after gastrectomy for gastric cancer, CONUT and LMR provide complementary prognostic information. Their combined use enhances survival stratification and may support earlier identification of patients with high-risk trajectories.<\/jats:p>","DOI":"10.3390\/nu18030451","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:19:38Z","timestamp":1769761178000},"page":"451","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Immuno-Nutritional Profiling for Survival Stratification in Gastrectomized Patients with Malignant Chronic Intestinal Failure"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6040-5112","authenticated-orcid":false,"given":"Konrad","family":"Matysiak","sequence":"first","affiliation":[{"name":"Centre for Intestinal Failure, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"},{"name":"Department of Gastroenterology, Poznan University Hospital, 60-355 Pozna\u0144, Poland"},{"name":"Department of General, Endocrine and Gastroenterological Oncology Surgery, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6875-8868","authenticated-orcid":false,"given":"Magdalena","family":"Szewczuk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Poznan University Hospital, 60-355 Pozna\u0144, Poland"},{"name":"Department of Internal Medicine, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5800-6306","authenticated-orcid":false,"given":"Aleksandra","family":"Hojdis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Poznan University Hospital, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-6940","authenticated-orcid":false,"given":"Tomasz","family":"Banasiewicz","sequence":"additional","affiliation":[{"name":"Department of General, Endocrine and Gastroenterological Oncology Surgery, Poznan University of Medical Sciences, 60-355 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1002\/cac2.12197","article-title":"Cancer Incidence, Mortality, and Burden in China: A Time-trend Analysis and Comparison with the United States and United Kingdom Based on the Global Epidemiological Data Released in 2020","volume":"41","author":"Qiu","year":"2021","journal-title":"Cancer Commun."},{"key":"ref_2","first-page":"394","article-title":"Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. 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