Study Evaluating the Efficacy of the myDIET Software Tool in the Nutritional Management of Patients With Localized and Resectable Gastric or Esogastric Junction Cancer.

Gastric cancer is the 3rd leading cause of cancer mortality worldwide, with a 5-year survival rate of less than 30%. In localised gastric cancer (GC) or cancer of the oesogastric junction (OGJ), the standard treatment consists of gastrectomy and peri-operative FLOT-based chemotherapy (5FU, Leucovorin, Oxaliplatin, Taxotere). However, up to 51% of patients have post-operative complications, and only 60% can benefit from post-operative chemotherapy (at least one course) initiated within 12 weeks of surgery, while 46% receive the full theoretical regimen.

An incomplete adjuvant chemotherapy regimen drastically reduces post-operative prognosis. Undernutrition and sarcopenia increase the occurrence of post-operative complications, length of stay and post-operative readmissions. Undernutrition is an independent risk factor for failure and/or incomplete adjuvant chemotherapy, with an impact on progression-free survival and overall survival. There is a high prevalence of undernutrition in patients with GC/OGJ, estimated at 53-60%, and the proportion of undernourished patients increases significantly postoperatively compared with preoperatively.

Preoperative nutrition and physical activity in sarcopenic patients has been shown to reduce postoperative complications. Early multimodal management, combining nutrition, adapted physical activity and neoadjuvant chemotherapy, is therefore recommended and essential in the perioperative situation. To optimise the nutritional management of patients with operable gastric or oesogastric junction cancer, the CLB teams have developed a computer interface (MyDIET) linked to the myCLB patient portal. This provides semi-personalised monitoring based on self-questionnaires designed to assess and educate patients or their carers about nutritional issues from the outset of oncology treatment, and to prevent the onset or worsening of undernutrition.

For this reason, the sponsor proposes an exploratory study to assess the efficacy of the myDIET digital tool in increasing the proportion of patients with localised CG/OGJ initially treated with neo-adjuvant chemotherapy and who undergo surgery and are able to receive adjuvant chemotherapy within 8 weeks post-operatively.

• Adherence to the tool [Срок оценки: From inclusion and up to 6 months after surgery]
• Number of supportive care and emergency consultations initiated by the caregiver [Срок оценки: From inclusion and up to 6 months after surgery]
• Proportion of patients with malnutrition [Срок оценки: From inclusion and up to 6 months after surgery]
• Evolution of body composition in L3 section (volumes) [Срок оценки: From inclusion and up to 6 months after surgery]
• Evolution of body composition in L3 section (indexes) [Срок оценки: From inclusion and up to 6 months after surgery]
• Evolution of resting energy expenditure [Срок оценки: From inclusion and up to 1 month after surgery]
• Proportion of patient covering theoretical nutritional requirement >= 30kcal/kg/day [Срок оценки: From inclusion and up to 6 months after surgery]
• Comparison between theoretical nutritional requirement and measurement of basal metabolic rate using indirect calorimetry [Срок оценки: From inclusion and up to 6 months after surgery]
• Weight changes [Срок оценки: From inclusion and up to 6 months after surgery]
• Brachial circumference changes [Срок оценки: From inclusion and up to 6 months after surgery]
• Triceps skin fold changes [Срок оценки: From inclusion and up to 6 months after surgery]
• Initiation time for post-operative treatment [Срок оценки: From surgery to date of post operative treatment initiation assessed up to 6 months after surgery]