Risk factors for severe weight loss after gastrectomy for gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 38-38
Author(s):  
Kenki Segami ◽  
Toru Aoyama ◽  
Taiichi Kawabe ◽  
Shigeya Hayashi ◽  
Yousuke Makuuchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Blood Loss ◽  
Total Gastrectomy ◽  
Significant Risk ◽  
Operation Time ◽  
Time Range ◽  
Eras Protocol

38 Background: Body weight loss (BWL) is frequently observed in gastric cancer patients who underwent gastrectomy for gastric cancer. Recently, we reported that severe BWL after gastrectomy was a significant risk factor for continuation of S-1 adjuvant chemotherapy. However, risk factors of BWL after surgery remain unclear. Methods: The present study retrospectively examined the patients who electively underwent curative gastrectomy for gastric cancer between January of 2012 and June of 2014. All patients received peri-operative care of ERAS protocol. %BWL was calculated by percentile of body weight at one month after surgery to preoperative body weight. Severe BWL was defined as %BWL over 10%. Risk factors for severe BWL were determined by both univariate and multivariate logistic regression analyses. Results: Two-hundred seventy eight patients were examined. Median age (range) was 68 years (27-86). Median body mass index (range) was 22 (13.4-33.5). Thirty patients had received neoadjuvant chemotherapy. Operative procedure was total gastrectomy (TG) in 97 patients (Open in 61 and laparoscopic in 36) and distal gastrectomy (DG) in 181 patients (Open in 94 and laparoscopic in 87). Median operation time (range) was 268.5 minutes (95-554). Median blood loss (range) was 115 mL (0-1600). Morbidity of grade 2 or more defined by Clavien-Dindo classification was observed in 37 patients including pancreatic fistula in 8, anastomotic leakage in 5, and abdominal abscess in 3. No mortality was found. Completion of ERAS protocol without any variance was 95.3%. Median %BWL was 6% (-4.3% to 19.5%). Both univariate and multivariate logistic analyses demonstrated that morbidity (odds rate 3.56, p=0.001), blood loss over 300ml (odds rate 2.04, p=0.0356), and total gastrectomy (odds rate 2.1, p=0.0258) were significant risk factors for severe BWL. Conclusions: Nutritional intervention trial to inhibit BWL after gastrectomy should be focused on the patients who developed morbidity, showed blood loss over 300ml, or received total gastrectomy.

Risk factors for loss of lean body mass after gastrectomy for gastric cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 79-79
Author(s):  
Toru Aoyama ◽  
Tsutomu Sato ◽  
Kenki Segami ◽  
Yukio Maezawa ◽  
Kazuki Kano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Mass Loss ◽  
Total Gastrectomy ◽  
Lean Body Mass ◽  
Body Mass ◽  
Surgical Complications ◽  
Significant Risk ◽  
Cancer Center ◽  
Body Mass Loss

79 Background: Lean body mass loss after surgery, which decreases compliance of adjuvant chemotherapy, is frequently observed in gastric cancer patients who underwent gastrectomy for gastric cancer. However, the risk factors of lean body mass loss remain unclear. Methods: The present study retrospectively examined the patients who underwent curative gastrectomy for gastric cancer between June 2010 and March 2014 at Kanagawa Cancer Center. All patients received perioperative care of the enhanced recovery after surgery protocol. % Lean body mass loss was calculated by percentile of lean body mass at one month after surgery to preoperative lean body mass. Severe lean body mass loss was defined as % lean body mass loss over 5%. Risk factors for severe lean body mass loss were determined by both univariate and multivariate logistic regression analyses. Results: Four-hundred eighty five patients were examined. Median age was 67 years. Operative procedure was total gastrectomy in 190 patients and distal gastrectomy in 295 patients. Surgical complications of grade 2 or more defined by Clavien-Dindo classification was observed in 78 patients including pancreatic fistula in 19, anastomotic leakage in 11 and abdominal abscess in 7. Mortality was observed in one patient. Both univariate and multivariate logistic analyses demonstrated that surgical complications (odds rate 3.576, p = 0.001), total gastrectomy (odds rate 2.522, p = 0.0001), and gender (odds rate 1.928, p = 0.001) were significant independent risk factors for severe lean body mass loss. Conclusions: Male, surgical complications, and total gastrectomy were significant risk factors for 5% of lean body mass loss at first month after gastrectomy. To maintain lean body mass after gastrectomy, the physician need careful attention for the patients who had these risk factors.

Risk factors that affect continuation of S-1 chemotherapy as an adjuvant setting after radical gastrectomy for gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 151-151
Author(s):  
Daisuke Kobayashi ◽  
Chie Tanaka ◽  
Naoki Iwata ◽  
Mitsuro Kanda ◽  
Suguru Yamada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Adverse Effects ◽  
Body Weight Loss ◽  
Standard Of Care ◽  
Current Standard ◽  
Curative Gastrectomy ◽  
Group 13

151 Background: Based on the evidence from ACTS-GC trial, postoperative S-1 administration for 12 months is the current standard of care in Japan for patients with pathological Stage II/III gastric cancer treated with D2 gastrectomy. However, the proportion of patients who actually tolerated 12 months of treatment in the ACTS-GC trial was 65.8%. In the present study, we explored the risk factors that could affect the compliance of S-1 adjuvant therapy. Methods: This retrospective study selected 68 consecutive patients who underwent curative gastrectomy for gastric cancer and received S-1 chemotherapy at our institution between 2003 and 2012. Associations between S-1 compliance, adverse effects and clinical characteristics were analyzed. Results: 51 patients were male, and 17 were female. Patient age ranged between 20 and 80 years (median: 64.0). 47 patients (69%) completed the prescribed S-1 treatment for 1 year. In addition, 5 patients discontinued treatment due to recurrence within 1 year, and 3 patients due to reasons irrelevant to the S-1 toxicity. These 55 patients were designated as non-AE group. The remaining 13 patients (19%) were obliged to discontinue S-1 due to adverse effects within 1 year (AE group). The percentage of female was higher in the AE group (46% versus 20% in the non-AE group). The median age of patients was significantly higher in the AE group (72 versus 63 in the non-AE group, p=0.004). Although there was no difference in the serum creatinine level at the beginning of the treatment, creatinine clearance (CCr) of AE group was significantly lower at 65 mL/min (83 mL/min for the non-AE group, p=0.04). Median body weight loss during the first 3 postoperative months in the AE group (13% of the original weight) was significantly higher (10% in the non-AE group, p=0.04), although the median body weight before treatment didn’t differ between the two groups. Dose reduction was more diligently conducted among the population with CCr< 60 in the non-AE group (4/7) than in the AE group (1/5). Conclusions: Female, old age, low CCr and greater body weight loss affect compliance of the S-1 adjuvant chemotherapy. Meticulous dose modification is required for those with risk for discontinuation.

scholarly journals Influence of Visceral Fat on Early Postoperative Outcomes After Distal and Total Gastrectomy for Gastric Cancer

2017 ◽  
Vol 102 (1-2) ◽  
pp. 95-99
Author(s):  
Chikashi Shibata ◽  
Hitoshi Ogawa ◽  
Kaori Koyama ◽  
Kazuaki Mukouda ◽  
Hajime Iwasashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Total Gastrectomy ◽  
Visceral Fat ◽  
Distal Gastrectomy ◽  
Operation Time ◽  
Patient Characteristics ◽  
Postoperative Outcomes ◽  
Visceral Fat Area ◽  
Clinical Records

We studied the influence of visceral fat area (VFA) on early postoperative outcomes separately after distal and total gastrectomy. The influence of obesity on outcomes might differ between distal and total gastrectomy, but few studies have directly compared the effects of VFA on early postoperative results between these 2 procedures. We reviewed clinical records of 124 patients with gastric cancer undergoing curative distal or total gastrectomy. Patients were classified into 2 groups: low (&lt;100 cm2) or high (≥100 cm2) VFA. Patient characteristics and early postoperative outcomes were compared between 2 groups separately in distal or total gastrectomy. There were 77 and 47 patients who underwent distal and total gastrectomy, respectively. After distal gastrectomy, operation time (268 ± 44 versus 239 ± 39 minutes, P &lt; 0.05) as well as blood loss (351 ± 231 versus 239 ± 147 mL, P &lt; 0.05) was increased in the high VFA group (N = 32) compared to the low VFA group (N = 45), but morbidity rates did not differ between the 2 groups (50% versus 36%). After total gastrectomy; operation time (285 ± 42 versus 260 ± 53 minutes, P &lt; 0.05); blood loss (427 ± 326 versus 280 ± 179 mL, P &lt; 0.05); rate of morbidity (56% versus 24%, P &lt; 0.05); and intra-abdominal infection (17% versus 0%, P &lt; 0.05) were increased in the high VFA group (N = 18) compared to the low VFA group (N = 29). These results suggest that postoperative morbidity increases after total gastrectomy but not after distal gastrectomy in patients with excessive visceral fat.

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

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9390
Author(s):  
Qiuju Tian ◽  
Liyuan Qin ◽  
Weiyi Zhu ◽  
Shaojie Xiong ◽  
Beiwen Wu
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Cancer Patients ◽  
Total Gastrectomy ◽  
Weight Change ◽  
Body Weight Loss ◽  
Body Weight Change ◽  
Generalized Estimation Equation ◽  
Gastric Cancer Patients

Aims The study aimed to explore factors contributing to body weight change over time in gastric cancer patients after gastrectomy, in order to find risk factors to implement nutritional intervention beforehand. Methods A cohort of gastric cancer patients who were treated with gastrectomy from January to March 2019 at a university affiliated hospital in Shanghai were consecutively identified in this study. Demographics, disease related information, nutrition knowledge, attitude, and practice score were collected before gastrectomy. In addition, body weight before surgery (T0), body weight at one month (T1), two months (T2), and three months (T3) after gastrectomy were recorded. Generalized estimation equation was used to describe body weight change and analyze factors contributing to body weight change after surgery. Results There were 49 patients recruited in the study. Patient body weight decreased by 9.2% at T1 (Wald χ = 271.173, P <0.001), 11.0% at T2 (Wald χ2 = 277.267, P <0.001), and 11.4% at T3 compared to baseline at T0 (Wald χ = 284.076, P <0.001). The results of GEE for multivariable analysis showed that surgery type (Wald χ = 6.027, P = 0.014) and preoperative BMI (Wald χ = 12.662, P = 0.005) were contributing factors of body weight change. Compared with distal gastrectomy patients, total gastrectomy patients experienced greater body weight loss (β = 2.8%, P = 0.014). Compared with patients with BMI&λτ; 18.5 kg/m2, patients with BMI ≥ 25 kg/m2experienced greater body weight loss (β = 4.5% P = 0.026). Conclusion Gastric cancer patients experienced significant weight loss during 3 months after gastrectomy. Total gastrectomy and BMI ≥ 25 kg/m2were risk factors to postoperative body weight loss for GC patients. The results suggested hinted that clinician should pay attention to postoperative nutrition status of patient undergoing total gastrectomy and obesity patients.

Long-term effects of an oral elemental nutritional supplement on post-gastrectomy body weight loss in gastric cancer patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 94-94
Author(s):  
Kazuhiro Nishikawa ◽  
Yutaka Kimura ◽  
Kentaro Kishi ◽  
Kentaro Inoue ◽  
Jin Matsuyama ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Cancer Patients ◽  
Total Gastrectomy ◽  
Body Weight Loss ◽  
Nutritional Intervention ◽  
Control Group ◽  
Gastric Cancer Patients

94 Background: Postoperative weight loss could have a negative effect on quality of life and prognosis of gastric cancer patients. We have already shown that daily nutritional intervention with an oral elemental diet (ED) attenuated the short-term postoperative percentage of body weight loss (% BWL) in post-gastrectomy patients, especially in underwent total gastrectomy (TG). This study was conducted to evaluate the postoperative long-term BWL of nutritional intervention. Methods: This study was conducted in a cohort of consecutive patients which were randomly allocated to receive the control or ED diet in the original trial. Control group received the regular diet alone after gastrectomy, while ED group received 300 kcal of ED plus their regular diet for 6–8 weeks. The primary endpoint was the % BWL from the presurgical bodyweight to that at 1 year after surgery by surgical type. Secondary endpoints were changes in nutrition-related blood parameters. Results: One hundred six of registered patients in the original trial were eligible for efficacy analyses. There was not significant difference in the % BWL between the two groups (9.13 ± 7.72 % vs. 7.09 ± 7.49 %, respectively; p = 0.171). The % BWL at one year after surgery was significantly lower in ED group than in control group among patients who underwent TG (n = 19 and 17, respectively; 9.66 ± 5.98% vs. 15.11 ± 6.78%, respectively; p = 0.015), but not in patients who underwent distal gastrectomy (DG) (n = 38 and 32, respectively; 5.81 ± 7.91% vs. 5.96 ± 6.20%, respectively; p = 0.933). A multivariate analysis revealed that only type of gastrectomy was independently associated with % BWL at 1 year after surgery. And in total gastrectomy, ED administration was independently associated with % BWL. Total lymphocyte count in ED group increased more than that in control group at 1 year after surgery. Conclusions: Nutritional intervention with ED at 300 kcal per day for 6–8 weeks reduced body weight loss at 1 year as well as 6-8 weeks after surgery in patients who underwent total gastrectomy. Clinical trial information: 000023455.

scholarly journals 1399P Risk factors for body weight loss after gastrectomy for gastric cancer analysed from the JCOG1001 phase III trial

2021 ◽  
Vol 32 ◽  
pp. S1056
Author(s):  
T. Yamada ◽  
Y. Kurokawa ◽  
J. Mizusawa ◽  
A. Takeno ◽  
J. Hihara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Body Weight Loss ◽  
Phase Iii ◽  
Phase Iii Trial

scholarly journals Our experience with laparoscopic total gastrectomy for gastric cancer: A case series

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Manash Ranjan Sahoo ◽  
Satyajit Samal ◽  
Jyotirmay Nayak
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Total Gastrectomy ◽  
Median Time ◽  
Operative Time ◽  
Laparoscopic Total Gastrectomy ◽  
Oral Feeding ◽  
Care Hospital ◽  
Intraoperative Blood Loss

Background: Though laparoscopic distal gastrectomy has become a standard procedure for treatment of gastric cancer, laparoscopic total gastrectomy has not been widely accepted as it requires more dexterity and lack of evidence about its feasibility and safety. Methods: Here retrospectively we review a series of 12 cases of gastric cancer undergone laparoscopic total gastrectomy with D1 or D2 lymphadenectomy over a period of 7 years at a tertiary care hospital. The patient demographic characteristics were reviewed and the outcomes after surgery was analyzed in terms of extent of lymphadenectomy, mean operative time, mean intraoperative blood loss median number of lymph nodes harvested, median time for postoperative ambulation, median time for postoperative oral feeding, median time of postoperative hospital stay, postoperative complications and mortality. Results: All patients had total gastrectomy entirely through laparoscopic method. Mean operative time was 282 minutes, mean intraoperative blood loss was 120 ml, median time for ambulation and oral feeding was 3 days and 6 days respectively. Median time of hospital stay was 16 days and 2 patients had complications as pancreatic fistula and port site abscess. No mortality was observed. Conclusion: With zero mortality and accepted rate of complications, laparoscopic total gastrectomy appears to be technically feasible and safe for management of gastric cancer. But more studies have to be conducted with comparison to other standard gastrectomies and long term follow up to be done to establish its standardized application.

Sign in / Sign up

Export Citation Format

Share Document