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Frailty, Immunonutrition, Surgery Type, and Biologic Recovery in Elderly Gastric Cancer

2. september 2026 opdateret af: Adem Yüksel, Kocaeli City Hospital

The Effects of Multidimensional Frailty Phenotypes, Immunonutritional Status, and Surgical Approach on Biological Recovery in Elderly Patients Undergoing Gastric Cancer Surgery: A Prospective Observational Study

This prospective observational cohort study will evaluate the effects of multidimensional frailty phenotypes, immunonutritional status, and surgical approach on biological recovery in patients aged 60 years and older undergoing surgery for gastric cancer. Preoperative assessment will include physical and cognitive frailty, nutritional status, handgrip strength, and skeletal muscle characteristics on computed tomography. Patients will be followed prospectively during the perioperative period, including assessment of inflammatory markers, postoperative complications, delirium, hospital length of stay, and functional recovery. The study aims to determine whether multidimensional frailty and immunonutritional factors are associated with postoperative outcomes and whether surgical approach influences biological recovery in older patients with gastric cancer. A total of 328 patients are planned to be included at Kocaeli City Hospital.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This prospective, observational, analytical cohort study will be conducted at the General Surgery Clinic of Kocaeli City Hospital. The study will include patients aged 60 years and older who have gastric cancer and are scheduled for elective radical gastrectomy. A total of 328 patients are planned to be enrolled.

Preoperative assessment will include multidimensional frailty-related parameters, including the modified Frailty Index-11 (mFI-11), Montreal Cognitive Assessment (MoCA), handgrip strength, Nutritional Risk Screening 2002 (NRS-2002), Prognostic Nutritional Index (PNI), and skeletal muscle characteristics assessed on computed tomography at the L3 level. Baseline neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels will also be recorded.

Intraoperative data will include surgical approach, operative duration, and intraoperative blood loss. Postoperatively, NLR and CRP will be assessed on postoperative days 1, 3, and 5. Delirium will be evaluated using the Confusion Assessment Method (CAM). Postoperative complications will be recorded according to the Clavien-Dindo classification, together with hospital length of stay and handgrip strength before discharge.

The primary purpose of the study is to evaluate the association between multidimensional frailty phenotypes and postoperative outcomes and biological recovery in older patients undergoing gastric cancer surgery. The study will also investigate whether the surgical approach is associated with differences in biological recovery among patients with different frailty profiles.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

328

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • İZMİT
      • Kocaeli, İZMİT, Tyrkiet (Türkiye)
        • Kocaeli City Hospital
        • Kontakt:
        • Ledende efterforsker:
          • Adem Yuksel, Assoc.Prof.

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

The study population will consist of patients aged 60 years and older with gastric cancer who are scheduled for elective radical gastrectomy at the General Surgery Clinic of Kocaeli City Hospital. Eligible participants will be enrolled prospectively according to the predefined inclusion and exclusion criteria. A total of 328 participants are planned to be included.

Beskrivelse

Inclusion Criteria:

  • Age 60 years or older.
  • Histopathological or endoscopic diagnosis of gastric cancer.
  • Planned elective radical gastrectomy.
  • Written informed consent to participate in the study.

Exclusion Criteria:

  • Stage IV metastatic gastric cancer.
  • Requirement for emergency surgery.
  • Severe neurological or psychiatric disease preventing completion of cognitive testing.
  • Incomplete clinical data.
  • Refusal to participate in the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Laparoscopic Surgery
Patients undergoing elective radical gastrectomy through a laparoscopic approach. The surgical approach is determined by routine clinical practice and is not assigned by the study.
Elective radical gastrectomy performed using a laparoscopic approach as part of routine clinical care. The surgical approach is not assigned by the study
Open Surgery
Patients undergoing elective radical gastrectomy through an open approach. The surgical approach is determined by routine clinical practice and is not assigned by the study.
Elective radical gastrectomy performed using an open approach as part of routine clinical care. The surgical approach is not assigned by the study

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Rate of postoperative complication
Tidsramme: Up to 30 days post-operative
According to the Clavien-Dindo classification, the status of postoperative complications during index hospitalisation.
Up to 30 days post-operative

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Comparison of Changes in the Neutrophil-to-Lymphocyte Ratio (NLR)
Tidsramme: Preoperative baseline, day 1 post-operative, day 3 post-operative, day 5 post-operative
Change in neutrophil-to-lymphocyte ratio from preoperative baseline to postoperative days 1, 3, and 5
Preoperative baseline, day 1 post-operative, day 3 post-operative, day 5 post-operative

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Changes in C-reactive protein (CRP) levels during the postoperative period compared with baseline values
Tidsramme: Preoperative baseline, day 1 post-operative, day 3 post-operative, day 5 post-operative
Change in C-reactive protein from preoperative baseline to postoperative days 1, 3, and 5.
Preoperative baseline, day 1 post-operative, day 3 post-operative, day 5 post-operative
Rate of postoperative delirium
Tidsramme: Day 1 post-operative, day 2 post-operative, day 3 post-operative, day 4 post-operative, day 5 post-operative.
Occurrence of postoperative delirium assessed daily using the Confusion Assessment Method.
Day 1 post-operative, day 2 post-operative, day 3 post-operative, day 4 post-operative, day 5 post-operative.
Comparison of length of stay in hospital
Tidsramme: From date of surgery until date of hospital discharge, assessed up to 3 months
Hospital length of stay measured in days from surgery to hospital discharge.
From date of surgery until date of hospital discharge, assessed up to 3 months
Comparison of changes in hand grip strength
Tidsramme: Baseline, pre-discharge
Change in handgrip strength from the preoperative assessment to the pre-discharge assessment
Baseline, pre-discharge

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Adem Yuksel, Assoc.Prof., Kocaeli City Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. august 2028

Studieafslutning (Anslået)

1. august 2028

Datoer for studieregistrering

Først indsendt

25. august 2026

Først indsendt, der opfyldte QC-kriterier

2. september 2026

Først opslået (Faktiske)

3. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

3. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. september 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2026-194 (Medical Ethics Committee of Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

There is no plan to share individual participant data with other researchers.

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