Investigation of the Utility of Global Leadership Initiative on Malnutrition Criteria as Prognostic Factors in Patients Undergoing Adjuvant S-1 Chemotherapy for Biliary Tract Cancer

Background Biliary tract cancers (BTCs) have poor prognoses, with limited curative options beyond surgical resection. Adjuvant S-1 chemotherapy has shown survival benefits in Japanese patients with resected BTCs. However, prognostic factors influencing survival in these patients remain uncertain. In this study, we aimed to investigate the efficacy of preoperative nutritional status using Global Leadership Initiative on Malnutrition (GLIM) criteria as a prognostic factor in patients receiving adjuvant S-1 chemotherapy for BTCs. Methods In this retrospective study, we evaluated 58 patients who underwent curative surgery for BTCs, excluding intrahepatic cholangiocarcinoma, at Kobe University from 2013 to 2022, followed by adjuvant S-1 chemotherapy. Nutritional status was classified by GLIM criteria into normal/moderate and severe malnutrition groups. Overall survival (OS) and recurrence-free survival (RFS) were analyzed using Kaplan–Meier and Cox proportional hazards models. Results Of the 58 patients, 3.4% had no malnutrition, 72.5% had moderate malnutrition, and 24.1% had severe malnutrition. Patients with severe malnutrition had significantly worse OS (24.7% vs 52.5%, p  = 0.0014) and RFS (34.3% vs 52.0%, p  = 0.0066). Severe malnutrition was an independent prognostic factor for both OS (hazard ratio [HR]: 3.40; 95% confidence interval [CI]: 1.46–7.94, p  = 0.0047) and RFS (HR: 2.48; 95% CI: 1.07–5.76, p  = 0.035). No significant difference in S-1 completion rates was observed. Conclusions Severe malnutrition, as defined by GLIM criteria, is a poor prognostic factor in patients with BTCs undergoing adjuvant S-1 chemotherapy.