Abstract
The basal metabolic rate (BMR) is a crucial indicator of the body's energy expenditure at rest and is essential for understanding metabolic needs. This retrospective study evaluated the prognostic significance of BMR in 521 predominantly Asian patients with stage I-III gastric cancer who underwent curative-intent resection. BMR was calculated using the Food and Agriculture Organization/World Health Organization/United Nations University (FWU BMR) equation. Multivariate Cox regression analysis identified FWU BMR as a significant predictor of overall survival (OS) (P < .001). Fractional polynomial modeling revealed a linear relationship between FWU BMR and OS, with higher values correlating with lower mortality risk. The FWU model, which included FWU BMR along with other clinical variables, showed superior predictive performance (C-index: 0.815, iAUC: 0.775) compared to that of the same model lacking BMR. Additionally, although the differences were not statistically significant, the FWU model also outperformed those using the BMR derived from alternative equations, including the Harris-Benedict equation. The nomogram, based on the FWU model, demonstrated good calibration. These findings suggest that the FWU BMR is a valuable prognostic factor in patients with gastric cancer post-resection, enhancing predictive accuracy and aiding in personalized post-surgical care. However, further validation in diverse populations is required.