Frailty, Immunonutrition, Surgery Type, and Biologic Recovery in Elderly Gastric Cancer

This prospective observational cohort study will evaluate the effects of multidimensional frailty phenotypes, immunonutritional status, and surgical approach on biological recovery in patients aged 60 years and older undergoing surgery for gastric cancer. Preoperative assessment will include physical and cognitive frailty, nutritional status, handgrip strength, and skeletal muscle characteristics on computed tomography. Patients will be followed prospectively during the perioperative period, including assessment of inflammatory markers, postoperative complications, delirium, hospital length of stay, and functional recovery. The study aims to determine whether multidimensional frailty and immunonutritional factors are associated with postoperative outcomes and whether surgical approach influences biological recovery in older patients with gastric cancer. A total of 328 patients are planned to be included at Kocaeli City Hospital.

Inclusion Criteria: * Age 60 years or older. * Histopathological or endoscopic diagnosis of gastric cancer. * Planned elective radical gastrectomy. * Written informed consent to participate in the study. Exclusion Criteria: * Stage IV metastatic gastric cancer. * Requirement for emergency surgery. * Severe neurological or psychiatric disease preventing completion of cognitive testing. * Incomplete clinical data. * Refusal to participate in the study.