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

2 september 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Beräknad)

328

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

  • Turkiet (Türkiye)
    • İZMİT
      • Kocaeli, İZMİT, Turkiet (Türkiye)
        • Kocaeli City Hospital
        • Kontakt:
        • Huvudutredare:
          • Adem Yuksel, Assoc.Prof.

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
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.
Procedur: Laparoscopic Gastrectomy
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.
Procedur: Open Gastrectomy
Elective radical gastrectomy performed using an open approach as part of routine clinical care. The surgical approach is not assigned by the study

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Rate of postoperative complication
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Comparison of Changes in the Neutrophil-to-Lymphocyte Ratio (NLR)
Tidsram: 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

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Changes in C-reactive protein (CRP) levels during the postoperative period compared with baseline values
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: Baseline, pre-discharge
Change in handgrip strength from the preoperative assessment to the pre-discharge assessment
Baseline, pre-discharge

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Kocaeli City Hospital

Utredare

  • Huvudutredare: Adem Yuksel, Assoc.Prof., Kocaeli City Hospital

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 september 2026

Primärt slutförande (Beräknad)

1 augusti 2028

Avslutad studie (Beräknad)

1 augusti 2028

Studieregistreringsdatum

Först inskickad

25 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

2 september 2026

Första postat (Faktisk)

3 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

3 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 september 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

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

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

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

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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