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16-01-2024 | Gastrectomy | Original Article

Effects of postoperative oral elemental nutritional supplement on skeletal muscle loss after gastrectomy for gastric cancer

Authors: Kazuhiro Nishikawa, Yutaka Kimura, Kentaro Kishi, Kentaro Inoue, Jin Matsuyama, Yusuke Akamaru, Shigeyuki Tamura, Junji Kawada, Tomono Kawase, Ryohei Kawabata, Yoshiyuki Fujiwara, Hitoshi Kanno, Takeshi Yamada, Toshio Shimokawa, Hiroshi Imamura

Published in: International Journal of Clinical Oncology | Issue 3/2024

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Abstract

Background

We previously showed that daily nutritional intervention with an oral elemental diet (ED) at 300 kcal/day for 6–8 weeks postoperatively decreased the percentage of body weight loss (%BWL), and that the effect was maintained for 1 year. This post hoc analysis aimed to determine whether this intervention decreased skeletal muscle mass loss 1-year post-gastrectomy.

Methods

Data from consecutive, untreated patients with histopathologically confirmed stage I–III gastric adenocarcinoma who planned to undergo total gastrectomy (TG) or distal gastrectomy (DG) and were enrolled in a previously published randomized trial were used. The primary endpoint was the percentage of skeletal muscle mass index (%SMI) loss from baseline at 1 year postoperatively, based on abdominal computed tomography images obtained preoperatively and at 1 year postoperatively.

Results

The overall median %SMI loss was lower in the ED versus control group, but the difference was not significant. The difference in %SMI loss in the ED and control groups was greater in patients with TG (10.1 vs. 13.0; P = 0.12) than in those with DG (5.5 vs. 6.8; P = 0.69). A correlation was observed between %BWL and %SMI loss in both groups (ED group, coefficient 0.591; control group, coefficient 0.644; P < 0.001 for both). Type of gastrectomy (coefficient 7.38; P = 0.001) and disease stage (coefficient − 6.43; P = 0.04) were independent predictors of postoperative skeletal muscle mass loss.

Conclusion

ED administration for 6–8 weeks following gastrectomy had no inhibitory effect on skeletal muscle loss at 1 year postoperatively.

Clinical Trial Registration

UMIN000023455.
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Metadata
Title
Effects of postoperative oral elemental nutritional supplement on skeletal muscle loss after gastrectomy for gastric cancer
Authors
Kazuhiro Nishikawa
Yutaka Kimura
Kentaro Kishi
Kentaro Inoue
Jin Matsuyama
Yusuke Akamaru
Shigeyuki Tamura
Junji Kawada
Tomono Kawase
Ryohei Kawabata
Yoshiyuki Fujiwara
Hitoshi Kanno
Takeshi Yamada
Toshio Shimokawa
Hiroshi Imamura
Publication date
16-01-2024
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology / Issue 3/2024
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-023-02462-3

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