Abstract: Objective  Malnutrition is a poor prognostic factor for many tumors.The current research mainly focuses on locally resectable or radical resectable gastric cancer.The purpose of this study was to investigate the effect of the nutritional risk index(NRI) on the prognosis of stage IV gastric cancer.
Methods  107 patients with civ gastric cancer diagnosed in Lishui Central Hospital from October 2011 to October 2015 were selected.By calculating the NRI,NRI < 97.5 was defined as malnutrition,and the correlation between age,gender,tumor location,metastasis location,body weight,body height index(BMI) and NRI,and the overall survival time of patients was analyzed.The NRI of patients after chemotherapy was reevaluated,and the relationship between the change of NRI and the overall survival time has been analyzed The correlation of survival time.
Result  Kaplan- Meier analysis showed that there was no significant correlation between age,gender,tumor location and treatment regimen and overall survival time(P>0.05).There was a significant correlation between tumor metastasis site and overall survival time(P<0.05).Cox regression analysis showed that BMI(P=0.017) and NRI(P=0.025) were independent factors of poor prognosis.In the chemotherapy subgroup analysis,the overall survival time of patients without malnutrition at the initial evaluation but with malnutrition during chemotherapy was significantly worse(17 months vs 13 months,χ2=4.366,P=0.037).However,there was no significant difference in the survival time of patients with malnutrition and still malnutrition at the initial assessment(9 months vs 10 months,χ2= 0.269,P=0.604).
Conclusion  NRI is an independent prognostic factor for patients with newly diagnosed stage IV gastric cancer,and in the chemotherapy subgroup,the overall survival of patients with malnutrition is significantly shorter than that of patients with good nutrition.NRI can be used as a nutritional assessment tool to help doctors to develop better treatment strategies.

Key words: nutritional risk index, stage Ⅳ gastric cancer, prognosis, Cox regression