Nutritional and Clinical Factors Affecting Weight and Fat-Free Mass Loss after Gastrectomy in Patients with Gastric Cancer

Abstract

After a gastrectomy, the nutritional status of patients with gastric cancer has great effect on the treatment outcome and patients’ quality of life. We investigated the changes in body composition and nutrient intake after gastrectomy in 288 gastric cancer patients. A multiple linear regression analysis was used for each time period to verify the effects of nutritional and clinical factors on weight and fat-free mass loss rates. Gastric cancer patients who underwent a gastrectomy continued to experience weight and fat-free mass loss until three months after surgery and became stagnant at six months. The marginal mean of calorie intake per weight was 24.5, 26.8, and 29.4 kcal at one, three, and six months. The protein intake per kg lean mass was 1.14, 1.14, and 1.16 g at one, three, and six months, respectively. One month after surgery, the rate of weight loss increased significantly in females who received chemotherapy (p < 0.001). At one to three months postoperative, females who had undergone chemotherapy tended to significantly lose weight (p = 0.016). Females with a history of chemotherapy also showed a reduction in fat-free mass for one to three months (p = 0.036). Calorie intake was a significant factor in preventing fat-free mass weight loss at one month after surgery. Chemotherapy was an independent factor affecting the weight and fat-free mass loss rate up to six months after gastrectomy. Careful monitoring of weight and muscle mass changes following active nutritional intervention for sufficient nutrition support could be helpful for patients after gastrectomy.

Prognostic Value of Albumin to D-Dimer Ratio in Advanced Gastric Cancer

“…Aside from inflammation, the relationship between poor nutritional status and tumors also deserves attention [ 41 ]. Unlike other diseases, GC patients usually have a higher nutritional risk due to persistent gastric outlet obstruction, dietary restriction, malabsorption, chronic blood loss, and tumor consumption [ 42 , 43 ]. A previous study has shown that 64.9% of GC patients have a Nutritional Risk Screening 2002 (NRS 2002) score of no less than 3, whereas for patients who underwent palliative surgery, the proportion of patients with NRS 2002 ≥ 3 increased to 68.6% [ 26 ].…”

Detection of sarcopenic obesity and prediction of long‐term survival in patients with gastric cancer using preoperative computed tomography and machine learning

“…We are currently exploring the usefulness of CT images for predicting postoperative complications, especially pancreatic fistulas, to independently validate the results of a previous study 39 . Postoperatively, the objective monitoring of muscle and fat loss after gastrectomy using follow‐up CT scans may allow appropriate interventions to potentially improve quality of life and survival 40,41 …”

“…39 Postoperatively, the objective monitoring of muscle and fat loss after gastrectomy using follow-up CT scans may allow appropriate interventions to potentially improve quality of life and survival. 40,41 Although this study showed the value of body composition analysis using machine learning based on preoperative CT images, it has some limitations. First, the surgery was performed by a single surgeon.…”

Prognostic Value of Pretreatment Overweight/Obesity and Adipose Tissue Distribution in Resectable Gastric Cancer: A Retrospective Cohort Study

“…Secondly, in Rodrigues’ study, obese gastric cancer patients in China accounted for less than 20% of the total number of cases, but over 60% accounted for Western obese gastric cancer patients, which may be the reason for the inconsistent results ( 7 ). Obese patients also have better physical and nutritional status than non-obese patients ( 28 , 29 ). As a result, obese patients are more likely to receive adjuvant treatment, including chemotherapy, which may improve prognosis.…”