Actual 5-Year Nutritional Outcomes of Patients with Gastric Cancer

Abstract

PurposeIn this study, we aimed to evaluate the rarely reported long-term nutritional results of patients with gastric cancer after curative gastrectomy.Materials and MethodsWe retrospectively reviewed the prospectively collected medical records of 658 patients who underwent radical gastrectomy with curative intent for gastric cancer from January 2008 to December 2009 and had no recurrences. All patients were followed for 5 years. Nutritional statuses were assessed using measurements of body weight, serum hemoglobin, total lymphocyte count (TLC), protein, albumin, cholesterol, and nutritional risk index (NRI).ResultsPatients who underwent total gastrectomy had lower body weights, hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued after the first postoperative year (P<0.05), and lower hemoglobin and NRI valued during the fifth postoperative year than patients who underwent distal gastrectomy (P<0.05). Patients who received adjuvant chemotherapy after gastrectomy had lower hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued during the first postoperative year, than those who underwent gastrectomy only (P<0.05). Regarding post-distal gastrectomy reconstruction, those who underwent Roux-en-Y had lower cholesterol levels than did those who underwent Billroth-I and Billroth-II reconstruction at the first and fifth years after gastrectomy, respectively (P<0.05).ConclusionsPatients undergoing total or distal gastrectomy with Roux-en-Y anastomosis or adjuvant chemotherapy after surgery should be monitored carefully for malnutrition during the first postoperative year, and patients undergoing total gastrectomy should be monitored for malnutrition and anemia for 5 years.

Pylorus-preserving gastrectomy for early cancer involving the upper third: can we go higher?

“…Even for upper third gastric cancer, distal subtotal gastrectomy can be performed in suitable cases [5,24,25]. Compared to total gastrectomy, DSG leads to better nutritional and function outcomes and can improve QOL [26,27]. Nonetheless, PPG, as a typical function-preserving gastrectomy, has been demonstrated to show further advantages in functional outcomes compared to distal gastrectomy in middle third EGC [7,28,29].…”

Prognostic Roles of Perioperative Body Mass Index and Weight Loss in the Long-Term Survival of Gastric Cancer Patients

“…Weight loss had to occur at a maximum of 6 to 12 months postoperatively, and body weight should remain stable for 1 year postoperatively according to previous studies (18,19). Nutritional data from SNUBH showed a similar pattern (12). In this study, postoperative BMI was calculated using the body weight measured in the outpatient clinic at 12 months after surgery for most patients (83.4%), and 9 (9.8%) or 6 (6.8%) months for the others.…”

“…Most patients who undergo gastrectomy experience body weight loss because of decreased food intake after surgery, and the postoperative body weight is maintained throughout the entire life after surgery (12). Therefore, both postoperative BMI and preoperative BMI need to be considered when evaluating long-term survival.…”

Preoperative nutritional risk index and postoperative one-year skeletal muscle loss can predict the prognosis of patients with gastric cancer: a registry based study

“…Indeed, our prior study demonstrated that skeletal muscle mass and nutritional parameters decrease sharply for the rst three months and slowly decrease for the remaining nine months, eventually leading to a loss of 8 ~ 15% of the initial body weight and 3 ~ 5% of the muscle area 3 . In addition, adjuvant chemotherapy, which is the standard treatment in stage 2 and 3 gastric cancer, exacerbates skeletal muscle loss and nutritional status of patients 4 .…”