Analysis of factors contributing to postoperative body weight change in patients with gastric cancer: based on generalized estimation equation

Tian, Qing; Qin, Liyuan; Zhu, Weiyi; Xiong, Shao-Jie; Wu, Beiwen

doi:10.7717/peerj.9390

Cited by 8 publications

(9 citation statements)

References 21 publications

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“…Most patients who undergo gastrectomy for gastric cancer experience weight loss as an inevitable postoperative complication. Postoperative weight loss was related to poor long-term survival of gastric cancer patients after gastrectomy, 4 However, overweight patients showed a higher survival rate in long-term follow-up observations for more than 9 years post-surgery than underweight patients or those with normal weight. 5 Several studies have shown different gut hormonal changes due to various surgical modalities.…”

Section: Introductionmentioning

confidence: 97%

Association Between Gut Regulatory Hormones and Post-operative Weight Loss Following Gastrectomy in Patients With Gastric Cancer

Jung

Tae

Lee

et al. 2022

J Neurogastroenterol Motil

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Background/AimsPost-operative weight loss in patients with gastric cancer lead to a poor quality of life and long-term survival. This study aims to evaluate the effects of gut regulatory hormones on post-operative weight loss in patients with subtotal gastrectomy for gastric cancer. MethodsThis prospective study was conducted for 12 months post-surgery in 14 controls and 13 gastrectomy patients who underwent subtotal gastrectomy for gastric cancer. Serum plasma ghrelin, glucagon-like peptide-1, gastric inhibitory peptide-1, peptide YY, insulin, and homeostatic model assessment for insulin resistance responses to a standardized test meal were recorded at multiple time points before and after gastrectomy at 4 and 12 months. ResultsThe mean weight difference between the pre-operative state and the 4-month period was significantly reduced to 6.6 kg (P = 0.032), but significant weight reduction was not observed from 4 months to 12 months. The plasma levels of glucagon-like peptide-1, gastric inhibitory peptide-1, and peptide YY were significantly increased 4 months postoperatively compared to the pre-operative state (all P = 0.035); however, pre-operative levels and relative changes over a period of 0-4 months of hormones were not correlated with body weight changes. Only the pre-operative ghrelin at peak had a negative correlation with changes in weight reduction in the 4 months after surgery (ρ = −0.8, P = 0.024). ConclusionsSignificant weight reduction was common after subtotal gastrectomy for gastric cancer with a negative correlation pre-operative plasma ghrelin levels. Incretin hormones are modestly but significantly increased after subtotal gastrectomy; however, these changes did not affect the weight changes.

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Section: Introductionmentioning

confidence: 97%

Association Between Gut Regulatory Hormones and Post-operative Weight Loss Following Gastrectomy in Patients With Gastric Cancer

Jung

Tae

Lee

et al. 2022

J Neurogastroenterol Motil

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“…We help patients to form a highprotein, high-calorie, and small-volume dietary pattern suitable for the characteristics of the postoperative gastrointestinal tract. Third, regarding the time frequency of intervention and adjustment, according to the results of previous studies, the weight loss of patients with GC was the largest within 90 days after surgery, especially within 30 days after surgery (6,14,37). Therefore, the duration of intervention in this study was determined to be within 90 days after surgery, which is a critical period for the reconstruction of patients' dietary patterns.…”

mentioning

confidence: 93%

“…However, GC surgery has caused reduction of food storage volume and various gastrointestinal symptoms, threatening the nutritional status of patients to varying degrees (3)(4)(5). Body weight loss and malnutrition are frequently observed in patients who undergo gastrectomy (6). Malnutrition has been indicated to have negative influence patients' clinical outcomes, including increased risk of recurrence, decreased tolerance to treatment, and quality of life (QOL) (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Effects of individualized dietary counseling on nutritional status and quality of life in post-discharge patients after surgery for gastric cancer: A randomized clinical trial

Yan

He²,

Wei³

et al. 2023

Front. Oncol.

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BackgroundCurrently, the supporting evidence for dietary counseling is insufficient. The aim of this study is to evaluate the impact of individualized dietary counseling on nutritional outcomes and quality of life (QOL) in patients undergoing surgery for gastric cancer.MethodsThis study was a prospective, single-center, randomized controlled trial. The patients after surgery for gastric cancer were randomly assigned (1:1) to the intervention group and the control group. In the intervention group, patients receive individualized dietary counseling based on individual calorie needs and symptom assessment at 24 h before discharge, 14, 21, 30, and 60 days postoperatively. Patients in the control group received routine dietary counseling. The primary endpoint was body mass index (BMI) loss at 30, 60, and 90 days after surgery; the secondary endpoints were calorie and protein intake at 30 and 60 days after surgery, blood parameters, the 90-day readmission rate, and QOL at 90 days after surgery.ResultsOne hundred thirty patients were enrolled; 67 patients were assigned to the intervention group and 63 patients to the control group. Compared with the control group, patients in the intervention group were significantly less BMI loss at 30 days (−0.84 ± 0.65 vs. −1.29 ± 0.83), 60 days (−1.29 ± 0.92 vs. −1.77 ± 1.13), and 90 days (−1.37 ± 1.05 vs. −1.92 ± 1.66) after surgery (all P< 0.05). Subgroups analysis by surgery type showed that the intervention could significantly reduce BMI loss in patients undergoing total and proximal gastrectomy at 30 days (−0.75 ± 0.47 vs. −1.55 ± 1.10), 60 days (−1.59 ± 1.02 vs. −2.55 ± 1.16), and 90 days (−1.44 ± 1.19 vs. −3.26 ± 1.46) after surgery (all P< 0.05). At 60 days after surgery, calorie goals were reached in 35 patients (77.8%) in the intervention group and 14 patients (40.0%) in the control group (P = 0.001), and protein goals were reached in 40 patients (88.9%) in the intervention group and 17 patients (48.6%) in the control group (P< 0.001). Regarding the QOL at 90 days after surgery, the patients in the intervention group had a significantly lower level of fatigue, shortness of breath and stomach pain, better physical function, and cognitive function (P< 0.05).ConclusionsPost-discharge individualized dietary counseling is an effective intervention to reduce post-gastrectomy patient weight loss and to elevate calorie intake, protein intake, and QOL.

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“…Insufficient attention has been paid to body weight change after GC surgery, and the descriptions of body weight change after GC surgery and its influencing factors differ across published studies. For example, an ongoing debate remains about the time point at which body weight loss is most pronounced[ 8 - 11 ], and the factors that influence the trend are inconsistent and unclear[ 9 , 12 , 13 ]. In addition, previous studies focused on demographic, clinicopathological, and therapeutic factors associated with body weight loss but did not consider other potential variables related to body weight loss, including increasingly prominent sociopsychological factors such as psychological distress.…”

Section: Introductionmentioning

confidence: 99%

Postoperative body weight change and its influencing factors in patients with gastric cancer

Li,

Huang,

Zhu

et al. 2024

World J Gastrointest Surg

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BACKGROUND The high incidence and mortality of gastric cancer (GC) pose a significant threat to human life and health, and it has become an important public health challenge in China. Body weight loss is a common complication after surgical treatment in patients with GC and is associated with poor prognosis and GC recurrence. However, current attention to postoperative weight change in GC patients remains insufficient, and the descriptions of postoperative weight change and its influencing factors are also different. AIM To investigate body weight changes in patients with GC within 6 mo after gastrectomy and identify factors that influence dynamic body weight changes. METHODS We conducted a prospective longitudinal study of 121 patients with GC and collected data before (T0) and 1 (T1), 3 (T2), and 6 (T3) mo after gastrectomy using a general data questionnaire, psychological distress thermometer, and body weight measurements. The general estimation equation (GEE) was used to analyze the dynamic trends of body weight changes and factors that influence body weight changes in patients with GC within 6 mo of gastrectomy. RESULTS The median weight loss at T1, T2, and T3 was 7.29% (2.84%, 9.40%), 11.11% (7.64%, 14.91%), and 14.75% (8.80%, 19.84%), respectively. The GEE results showed that preoperative body mass index (BMI), significant psychological distress, religious beliefs, and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy (P < 0.05). Compared with preoperative low-weight patients, preoperative obese patients were more likely to have weight loss (β = 14.685, P < 0.001). Furthermore, patients with significant psychological distress were more likely to lose weight than those without (β = 2.490, P < 0.001), and religious patients were less likely to lose weight 6 mo after gastrectomy than those without religious beliefs (β = -6.844, P = 0.001). Compared to female patients, male patients were more likely to experience weight loss 6 mo after gastrectomy (β = 4.262, P = 0.038). CONCLUSION Male patients with GC with high preoperative BMI, significant psychological distress, and no religious beliefs are more likely to lose weight after gastrectomy.

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Analysis of factors contributing to postoperative body weight change in patients with gastric cancer: based on generalized estimation equation

Cited by 8 publications

References 21 publications

Association Between Gut Regulatory Hormones and Post-operative Weight Loss Following Gastrectomy in Patients With Gastric Cancer

Association Between Gut Regulatory Hormones and Post-operative Weight Loss Following Gastrectomy in Patients With Gastric Cancer

Effects of individualized dietary counseling on nutritional status and quality of life in post-discharge patients after surgery for gastric cancer: A randomized clinical trial

Postoperative body weight change and its influencing factors in patients with gastric cancer

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