| Summary: | Abstract Background Nutritional risk assessment indices impact disease prognosis, yet their prognostic roles in preoperative digestive system tumor (DST) patients remain unclear. Methods In this study, the Controlling Nutritional Status (CONUT) score, the Nutritional Risk Index (NRI) and the Prognostic Nutritional Index (PNI) before surgery were applied to 17, 338 patients with 10 kinds of newly diagnosed DSTs. The distribution of nutritional risk and its correlation with mortality were examined in this study through the utilization of three nutritional risk assessment indices. Results The study encompassed 17,338 cases of DSTs, comprising 7,644 cases of gastric cancer, 5,542 cases of esophageal cancer, 2,826 cases of pancreatic cancer, 570 cases of gastroesophageal junction cancer, 185 cases of liver cancer, and minimal instances of five other tumor types, each numbering approximately 100. According to the 3 nutritional risk assessment indices, CONUT, NRI and PNI, nutrition risk was common in patients with DSTs (79.24% with CONUT, 38.91% with NRI, 3.13% with PNI), and even in patients with normal or high BMI. In gastric cancer, in addition to age, stage, presence of metastasis, and tumor tissue type, three nutritional risk assessment indices could effectively stratify the prognosis based on nutritional status. CONUT was valuable for predicting the prognosis of intrahepatic cholangiocarcinoma, whereas NRI was significant in Esophageal Cancer and Pancreatic Cancer. Conclusions Nutritional risk was common among DSTs patients and was strongly associated with increased mortality in GC according to CONUT, NRI and PNI Stratification. More attention should be paid to nutritional risk assessment indices to improve prognosis, and prospective clinical trials were needed to evaluate the efficacy of nutritional interventions in GC patients. However, the utility of these three nutritional risk assessment indices in other DSTs was limited.
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