BACKGROUND
The correlation between body mass index (BMI) and cancer survival has been studied, and obesity is known to be a risk factor for various types of cancer. Though the importance of health management for cancer survivors is increasing, few studies have been conducted to determine the correlation between weight change and cancer survival based on longitudinal data. Since gastric cancer is a malignancy of the gastrointestinal tract, post-operative weight change is an important indicator for the management of the patient post-surgery.
OBJECTIVE
In this study, we analyzed the effect of changes in BMI with time on survival in gastric cancer patients on cancer survival to propose the direction of cancer patient weight management.
METHODS
8,795 patients diagnosed with gastric cancer in single hospital between January 1, 1994, and December 31, 2014, were enrolled in the study, and follow-up data were collected from the records until March 2018. The patients were divided into three groups based on the criteria of tumor extension (i.e., localized gastric cancer, gastric cancer with lymph node (LN) metastasis without distant metastasis, gastric cancer with distant metastasis). The degree of BMI change was divided into three groups based on the linear regression slope (slope value ≥ 0.5, ≤ - 0.5 or |slope value| < 0.5). Cancer-specific death to five years from the day of diagnosis, according to changes in BMI was analyzed using the Cox model and log-rank test.
RESULTS
Of the total 8,795 patients, average slope of weight change was -0.17. Patients without distant metastasis (n = 7536) had the best prognosis in the mid-group, whereas patients with distant metastasis (n = 1259) had the best prognosis in the prognosis in the rapidly-gaining weight group. In patients with distant metastasis, rapidly-losing weight was associated with a significant increase in gastric cancer mortality risk (HR = 1.66, p < 0.001).
CONCLUSIONS
The trend in weight change, rather than the weight at fixed time-points, must be considered during the management of the patient. It demonstrates the importance of weight management and nutritional support in gastric cancer patients. These findings may contribute as a basis for patient participation to improve gastric cancer survival.
Postoperative Body Mass Index Changes in Gastric Cancer Patients according to Reconstruction Type: Effectiveness of Long Jejunal Bypass on Weight Loss in Obese Patients after Distal Gastrectomy
