{ "abstract": "Purpose\n\nConventional radiologic assessment using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) may not fully capture clinical responses during immunotherapy. Therefore, we investigated the association between early weight gain (WG) and prognosis in this population.Materials and methods\n\nWe enrolled 268 consecutive patients with stage IV gastric cancer (GC) who received first-line combination immunotherapy. Data were obtained from a prospective clinical database. Cox regression and g-computation were used to quantify and visualize the associations between WG and progression-free survival (PFS) and overall survival (OS). The skeletal muscle index (SMI), subcutaneous fat index (SFI), and visceral fat index (VFI) at L3 were calculated using 3D Slicer.Results\n\nAfter a median follow-up of 29.7 months, 210 (78.3%) patients experienced disease progression and 185 (69.0%) died. The median overall survival (mOS) was 14.8 months, and the median progression-free survival (mPFS) was 7.2 months. The optimal cutoff value for WG was 4%, classifying patients into the WG ≥4% (n=87) and WG <4% (n=181) groups. WG ≥4% was associated with longer mOS (hazard ratio [HR], 0.225; P<0.001) and mPFS (HR, 0.449; P<0.001). WG ≥4% was also significantly associated with prolonged mOS in patients with stable disease (SD) (HR, 0.140; P<0.001) and progressive disease (PD) (HR, 0.045; P=0.003). Multivariate Cox regression analysis confirmed WG as an independent predictor of survival outcomes. SFI (r=0.34) and SMI (r=0.32) were moderately and positively correlated with OS.Conclusions\n\nWG ≥4% is associated with better survival outcomes in patients with stage IV GC undergoing combination immunotherapy, even in those with SD or PD.", "abstract_shown": true, "affiliations": [ "Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.", "Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumors, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.", "Cancer Center of Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.", "Medical Imaging Department, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.", "Department of Pathology, Nanfang Hospital, Southern Medical University, Guangzhou, China.", "Guangdong Province Key Laboratory of Molecular Tumor Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China. nana1800@smu.edu.cn.", "Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumors, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. Liuhaofbi@163.com.", "Cancer Center of Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China. gzliguoxin@163.com.", "Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumors, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. zlyblue11@163.com." ], "article_type": "research article", "arxiv": null, "author_total": 15, "authors": [ { "affs": [ 0, 1 ], "name": "Kaihua Huang", "orcid": "0009-0004-5135-7891" }, { "affs": [ 0, 1 ], "name": "Min Lai", "orcid": "0009-0005-8211-5075" }, { "affs": [ 0, 1 ], "name": "Huiming Zhang", "orcid": "0009-0003-8635-2129" }, { "affs": [ 2 ], "name": "Huayuan Liang", "orcid": "0000-0002-1966-6908" }, { "affs": [ 0, 1 ], "name": "Xiao Yan", "orcid": "0009-0009-5758-2578" }, { "affs": [ 3 ], "name": "Qingling Yu", "orcid": "0009-0002-6104-6355" }, { "affs": [ 0, 1 ], "name": "Huilin Huang", "orcid": "0009-0005-8657-6063" }, { "affs": [ 0, 1 ], "name": "Rou Zhong", "orcid": "0009-0005-9266-3702" }, { "affs": [ 0, 1 ], "name": "Qing Xie", "orcid": "0009-0006-0768-0303" }, { "affs": [ 0, 1 ], "name": "Xinru Liu", "orcid": "0009-0006-7404-8084" }, { "affs": [ 0 ], "name": "Zhiwei Li", "orcid": "0009-0007-6740-210X" }, { "affs": [ 4, 5 ], "name": "Lina Yu", "orcid": "0009-0008-3776-5580" }, { "affs": [ 0, 6 ], "name": "Hao Liu", "orcid": "0000-0003-1227-2954" }, { "affs": [ 0, 1, 7 ], "name": "Guoxin Li", "orcid": "0000-0003-2773-7048" }, { "affs": [ 0, 8 ], "name": "Liying Zhao", "orcid": "0000-0002-3723-5626" } ], "bibtex": "https://research.draconitic.com/paper/0esqwc8y41qdy.bib", "cited_by": 0, "doi": "10.5230/jgc.2026.26.e43", "fulltext_url": "https://europepmc.org/articles/PMC13655693", "id": "0esqwc8y41qdy", "issns": [ "2093-582X", "2093-5641" ], "landing_url": "https://europepmc.org/article/MED/42845256", "language": "eng", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2740|Gastric Cancer Management and Outcomes" ] ], "openalex": "W7214037598", "pdf_url": "https://europepmc.org/articles/PMC13655693?pdf=render", "pmcid": "PMC13655693", "pmid": "42845256", "published": "2026-10-01", "publisher": null, "ris": "https://research.draconitic.com/paper/0esqwc8y41qdy.ris", "sources": [ { "first_seen": "2026-10-30T12:18:10Z", "native_id": "MED:42845256", "source": "europepmc", "url": "https://europepmc.org/article/MED/42845256" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2740|Gastric Cancer Management and Outcomes", "subfield": "general" } ], "title": "Prognostic Value of Early Weight Gain in Patients With Stage IV Gastric Cancer Undergoing First-Line Combination Immunotherapy.", "title_text": "Prognostic Value of Early Weight Gain in Patients With Stage IV Gastric Cancer Undergoing First-Line Combination Immunotherapy.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:18:10Z", "url": "https://research.draconitic.com/paper/0esqwc8y41qdy", "venue": "Journal of gastric cancer", "versions": [] }