Method Article

Meta-analysis of Effects of Nutritional Therapies on Nutritional Status of Gastric Cancer Patients

DOI:

10.3791/69720

January 16th, 2026

In This Article

Summary

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This study found that oral supplements significantly increased weight, and early tube feeding improved prealbumin more than parenteral nutrition. However, specialized immunonutrition showed no added benefit over standard formulas for key blood proteins. Further research is needed to confirm these results.

Abstract

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This protocol provides a methodological framework for conducting a meta-analysis to evaluate the effects of nutritional therapies on the nutritional status of gastric cancer patients. By following this protocol, researchers will be able to systematically identify, appraise, and synthesize evidence from randomized controlled trials and comparative studies. The steps include: formulating a comprehensive search strategy across multiple databases; dual-independent screening and selection of studies using predefined PICOS criteria (population, interference, comparison, outcome, and study design); standardized data extraction and harmonization of outcome measures; assessment of study quality using the Cochrane Risk of Bias 2.0 tool; and statistical synthesis using appropriate models, with exploration of heterogeneity and sensitivity analyses. Application of this protocol to the available evidence suggests potential benefits of specific nutritional interventions, e.g., oral supplementation for body weight, though high heterogeneity underscores the need for rigorous and standardized methodology in this field. A continuous model with fixed or random effects was used to get the mean difference (MD) with 95% confidence intervals (CIs). A total of 18 studies, involving 3,586 subjects, were selected for the meta-analysis. Oral nutritional supplementation had a significantly increased body weight (MD, 0.74; 95% CI, 0.20-1.27, p = 0.007) compared to the control in patients with gastric cancer. Early enteral nutrition had significantly improved prealbumin levels (MD, 22.53; 95% CI, 13.37-31.69, p < 0.001) compared to parenteral nutrition in patients. However, no significant differences were found between enteral immunonutrition and standard enteral nutrition for albumin (MD, 0.57, 95%CI, -0.31-1.44, p=0.20), prealbumin (MD, 0.23, 95%CI, -0.29-0.76, p=0.38), or transferrin levels (MD, 0.11, 95%CI, -0.09-0.32, p=0.28). The studied data showed that using oral nutritional supplementation had significantly increased body weight compared to control, and early enteral nutrition had significantly improved prealbumin levels compared to parenteral nutrition. However, more studies are required to validate this finding.

Introduction

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Annually, almost 1 million instances of gastric cancer are diagnosed globally1. Despite a consistent decrease in incidence, gastric cancer continues to be one of the most prevalent and lethal neoplasms, accounting for 783,000 cases (8.2% of all cancer fatalities) in 20182. Surgery is the principal treatment for gastric cancer, with a 5-year survival rate of about 25.7% in cases of locally advanced disease in Europe and the United States3. Despite advancements in surgical techniques and perioperative care in recent years, a majority of gastric cancer patients experience significant malnutrition due....

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Protocol

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This study involves analysis of previously published data and does not require ethics approval or patient consent.

1. Developing the search strategy 9

  1. Search the following databases: PubMed, Cochrane Library, Embase, Google Scholar, and OVID. Use both Medical Subject Headings (MeSH) terms and free-text keywords in all searches. Apply no language or date restrictions.
  2. Document the search date and the number of records retrieved from each database.
  3. Develop search strings using the PICOS framework (population, intervention, comparison, outcome, and study design)

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Results

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Search results and study selection
A comprehensive literature search conducted on July 1, 2025, identified 3675 records from five databases. After removing 1226 duplicates, 2449 records underwent title and abstract screening. Of these, 148 full-text articles were assessed for eligibility, with 130 excluded for not meeting the inclusion criteria. Eighteen studies15,16,17,18

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Discussion

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Meta-analysis outcomes
For the current meta-analysis, 18 studies with 3586 subjects were studied15,16,17,18,19,20,21,22,23,24,25<.......

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Disclosures

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The authors declare that they have no competing interests.

Acknowledgements

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Not applicable.

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Materials

List of materials used in this article
NameCompanyCatalog NumberComments
Covidence for study screeningVeritas Health Innovation Ltd.https://www.covidence.org/
EndNote X9 Clarivatehttps://support.clarivate.com/Endnote/s/article/Download-EndNote?language=en_US
R statistical software (version 4.3.1) with metafor package for additional analysesthe r foundation for statistical computinghttps://www.r-project.org/
Review Manager 5.4 (The Cochrane Collaboration) for meta-analysis.The Nordic Cochrane Centre, the Cochrane Collaborationhttps://www.cochrane.org/learn

References

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  1. Rawla, P., Barsouk, A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Gastroenterol Rev. 14 (1), 26-38 (2019).
  2. Bray, F., et al. Global cancer statistics 2018: GLOBOCAN estimat....

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Tags

Nutritional TherapiesGastric CancerNutritional StatusMeta AnalysisOral Nutritional SupplementationEnteral NutritionParenteral NutritionRandomized Controlled TrialsBody WeightPrealbumin Levels

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