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Background <p>The increasing number of elderly patients with gastric cancer (GC) highlights the need for accurate prognostic assessment. Although several nutrition-related biomarkers have been proposed, their predictive abilities remain limited. Precise prediction of surgical outcomes is particularly important in elderly patients with reduced nutritional and physical reserves.</p> Methods <p>We developed a novel biomarker, the Albumin Grip Index (AGI), which was calculated as 10 × serum albumin (g/dL) + grip strength [kilogram-force (kgf)] to evaluate both nutritional and physical status. We retrospectively investigated 370 patients who underwent gastrectomy for GC from January 2016 to December 2023. Patients were divided into high and low AGI groups to examine its impact on overall survival (OS), cancer-specific survival (CSS), and major complications ( ≧ Clavien-Dindo grade 3). The prognostic performance of AGI was compared with other albumin-based biomarkers: Geriatric Nutrition Risk Index (GNRI), Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS).</p> Results <p>Low AGI was significantly associated with older age, malnutrition, impaired physical function, and advanced disease. The 5-year OS and CSS rates were significantly lower in the low AGI group than in the high AGI group. Major complications were also more frequent in the low AGI group. Multivariate analysis identified low AGI as an independent predictor of OS, CSS, and major complications. AGI showed superior prognostic performance to other albumin-based indices.</p> Conclusions <p>AGI is a simple and clinically practical biomarker integrating nutritional and physical status, and it effectively predicts survival and postoperative complications after gastrectomy for GC.</p>

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Preoperative albumin grip index as a novel biomarker predicting prognosis and postoperative complications after gastrectomy for gastric cancer

  • 期刊论文

  • 发表日期：

    2026年2月18日

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  • Katsunobu Sakurai,
  • Naoshi Kubo,
  • Tatsuro Tamura,
  • Yutaka Tamamori,
  • Tsuyoshi Hasegawa,
  • Junya Nishimura,
  • Yasuhito Iseki,
  • Tatsunari Fukuoka,
  • Takafumi Nishii,
  • Masakazu Yashiro,
  • Kiyoshi Maeda

摘要

Background

The increasing number of elderly patients with gastric cancer (GC) highlights the need for accurate prognostic assessment. Although several nutrition-related biomarkers have been proposed, their predictive abilities remain limited. Precise prediction of surgical outcomes is particularly important in elderly patients with reduced nutritional and physical reserves.

Methods

We developed a novel biomarker, the Albumin Grip Index (AGI), which was calculated as 10 × serum albumin (g/dL) + grip strength [kilogram-force (kgf)] to evaluate both nutritional and physical status. We retrospectively investigated 370 patients who underwent gastrectomy for GC from January 2016 to December 2023. Patients were divided into high and low AGI groups to examine its impact on overall survival (OS), cancer-specific survival (CSS), and major complications ( ≧ Clavien-Dindo grade 3). The prognostic performance of AGI was compared with other albumin-based biomarkers: Geriatric Nutrition Risk Index (GNRI), Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS).

Results

Low AGI was significantly associated with older age, malnutrition, impaired physical function, and advanced disease. The 5-year OS and CSS rates were significantly lower in the low AGI group than in the high AGI group. Major complications were also more frequent in the low AGI group. Multivariate analysis identified low AGI as an independent predictor of OS, CSS, and major complications. AGI showed superior prognostic performance to other albumin-based indices.

Conclusions

AGI is a simple and clinically practical biomarker integrating nutritional and physical status, and it effectively predicts survival and postoperative complications after gastrectomy for GC.