Effectiveness of a structured nutritional intervention on quality of life in gastric cancer patients following gastrectomy: a controlled clinical trial.

BACKGROUND: Gastric cancer and its surgical treatment impose a substantial burden on patients' physical and psychosocial functioning. Data from lower-middle income settings remain limited. This study evaluated the effectiveness of a structured nutritional intervention on quality of life (QoL) in gastric cancer patients following gastrectomy. METHODS: A controlled clinical trial with matched groups was conducted in Vietnam (October 2021-March 2024). A total of 102 post-gastrectomy gastric cancer patients were allocated to an intervention group (n = 52) or a control group (n = 50), matched by age, disease stage, and nutritional status. The intervention group received individualized nutritional support including high-energy dietary plans, oral nutritional supplements, and regular nutrition counselingover three months. The control group followed standard hospital or home dietary practices. QoL was assessed at baseline (T0: prior to surgery) and at three months (T4: after the third chemotherapy cycle) using the EORTC QLQ-C30. RESULTS: At three months, the intervention group showed statistically significant improvements across all functional scales, including physical (78.3 to 85.0), role (70.8 to 80.4), emotional (74.0 to 79.2), social (75.6 to 83.9), and global health status (57.1 to 69.5) (all p < 0.001); global health status was the pre-specified primary outcome for this analysis, while findings for the remaining individual functional domains should be considered secondary and exploratory. At the individual level, no participant in the intervention group experienced a clinically meaningful (≥10-point) deterioration in any functional domain, compared with 16-22% of control-group patients across domains. Symptom burden was markedly reduced in the intervention group, with significant improvements in fatigue (75.0% vs. 34.0%, p < 0.001), pain (78.8% vs. 50.0%, p = 0.006), and sleep disturbance (30.8% vs. 18.0%, p = 0.002). CONCLUSIONS: A structured nutritional intervention was associated with significant improvements in functional outcomes and reduced symptom burden post-gastrectomy, supporting further evaluation of its integration into standard oncology care in resource limited settings.