Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2016

01-06-2016 | Gastrointestinal Oncology

Risk Factors for the Loss of Lean Body Mass After Gastrectomy for Gastric Cancer

Authors: Toru Aoyama, MD, PhD, Tsutomu Sato, MD, PhD, Kenki Segami, MD, Yukio Maezawa, MD, Kazuki Kano, MD, Taiichi Kawabe, MD, Hirohito Fujikawa, MD, Tsutomu Hayashi, MD, Takanobu Yamada, MD, Kazuhito Tsuchida, MD, Norio Yukawa, MD, PhD, Takashi Oshima, MD, PhD, Yasushi Rino, MD, PhD, Munetaka Masuda, MD, PhD, Takashi Ogata, MD, PhD, Haruhiko Cho, MD, PhD, Takaki Yoshikawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2016

Login to get access

Abstract

Background

Lean body mass loss after surgery, which decreases the compliance of adjuvant chemotherapy, is frequently observed in gastric cancer patients who undergo gastrectomy for gastric cancer. However, the risk factors for loss of lean body mass remain unclear.

Methods

The current study retrospectively examined the patients who underwent curative gastrectomy for gastric cancer between June 2010 and March 2014 at Kanagawa Cancer Center. All the patients received perioperative care for enhanced recovery after surgery. The percentage of lean body mass loss was calculated by the percentile of lean body mass 1 month after surgery to preoperative lean body mass. Severe lean body mass loss was defined as a lean body mass loss greater than 5 %. Risk factors for severe lean body mass loss were determined by both uni- and multivariate logistic regression analyses.

Results

This study examined 485 patients. The median loss of lean body mass was 4.7 %. A lean body mass loss of 5 % or more occurred for 225 patients (46.4 %). Both uni- and multivariate logistic analyses demonstrated that the significant independent risk factors for severe lean body mass loss were surgical complications with infection or fasting (odds ratio [OR] 3.576; p = 0.001), total gastrectomy (OR 2.522; p = 0.0001), and gender (OR 1.928; p = 0.001).

Conclusions

Nutritional intervention or control of surgical invasion should be tested in future clinical trials for gastric cancer patients with these risk factors to maintain lean body mass after gastrectomy.
Literature
1.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.CrossRefPubMed
2.
Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810–20.CrossRefPubMed
3.
Bang YJ, Kim YW, Yang HK, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomized controlled trial. Lancet. 2012;379:315–21.CrossRefPubMed
4.
Bonadonna G, Valagussa P. Dose-response effect of adjuvant chemotherapy in breast cancer. N Engl J Med. 1981;304:101–5.CrossRef
5.
Aoyama T, Kawabe T, Fujikawa H, et al. Loss of lean body mass as an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol. 2015;22:2560–6.CrossRefPubMed
6.
Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.CrossRef
7.
Yamada T, Hayashi T, Cho H, et al. Usefulness of enhanced recovery after surgery protocol as compared with conventional perioperative care in gastric surgery. Gastric Cancer. 2012;15:34–41.CrossRefPubMed
8.
Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.CrossRef
9.
Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.CrossRefPubMed
10.
Hayashi T, Yoshikawa T, Aoyama T, et al. Impact of infectious complications on gastric cancer recurrence. Gastric Cancer. 2015;18:368–74.CrossRefPubMed
11.
Kiyama T, Mizutani T, Okuda T, et al. Postoperative changes in body composition after gastrectomy. J Gastrointest Surg. 2005;9:313–9.CrossRefPubMed
12.
Traustadottir T, Bosch PR, Matt KS. Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women. Stress. 2003;6:133–40.CrossRefPubMed
13.
Stupka N, Lowther S, Chorneyko K, Bourgeois JM, Hogben C, Tarnopolsky MA. Gender differences in muscle inflammation after eccentric exercise. J Appl Physiol. 2000;89:2325–32.PubMed
14.
Kerksick C, Taylor L IV, Harvey A, Willoughby D. Gender-related differences in muscle injury, oxidative stress, and apoptosis. Med Sci Sports Exerc. 2008;40:1772–80.CrossRefPubMed
15.
Staron RS, Hikida RS, Murray TF, Nelson MM, Johnson P, Hagerman F. Assessment of skeletal muscle damage in successive biopsies from strength-trained and untrained men and women. Eur J Appl Physiol Occup Physiol. 1992;65:258–64.CrossRefPubMed
16.
Komulainen J, Koskinen SO, Kalliokoski R, Takala TE, Vihko V. Gender differences in skeletal muscle fibre damage after eccentrically biased downhill running in rats. Acta Physiol Scand. 1999;165:57–63.CrossRefPubMed
17.
Noguchi Y, Tsuburaya A, Makino T, et al. Metabolic alteration in totally gastrectomised patients: caloric intake and energy consumption. Asian J Surg. 1992;15:97–102.
18.
Shintani M, Ogawa Y, Ebihara K, et al. Ghrelin, an endogenous growth hormone secretagogue, is a novel orexigenic peptide that antagonizes leptin action through the activation of hypothalamic neuropeptide Y/Y1 receptor pathway. Diabetes. 2001;50:227–32.CrossRefPubMed
19.
Masuda Y, Tanaka T, Inomata N, et al. Ghrelin stimulates gastric acid secretion and motility in rats. Biochem Biophys Res Commun. 2000;276:905–8.CrossRefPubMed
20.
21.
Takachi K, Doki Y, Ishikawa O, et al. Postoperative ghrelin levels and delayed recovery from body weight loss after distal or total gastrectomy. J Surg Res. 2006;130:1–7.CrossRefPubMed
22.
Adachi S, Takiguchi S, Okada K, et al. Effects of ghrelin administration after total gastrectomy: a prospective, randomized, placebo-controlled phase II study. Gastroenterology. 2010;138:1312–20.CrossRefPubMed
23.
Dornonville de la Cour C, Lindqvist A, Egecioglu E, Tung YC, Surve V, Ohlsson C, et al. Ghrelin treatment reverses the reduction in weight gain and body fat in gastrectomised mice. Gut. 2005;54:907–13.CrossRefPubMedPubMedCentral
24.
Cruickshank AM, Fraser WD, Burns HJ, et al. Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci. 1990;79:161–5.CrossRefPubMed
25.
Castell JV, Gómez-Lechón MJ, David M, et al. Interleukin-6 is the major regulator of acute phase protein synthesis in adult human hepatocytes. FEBS Lett. 1989;242:237–9.CrossRefPubMed
26.
Mansoor O, Beaufrere B, Boirie Y, et al. Increased mRNA levels for components of the lysosomal Ca2 activated, and ATP-ubiquitin-dependent proteolytic pathways in skeletal muscle from head trauma patients. Proc Natl Acad Sci USA. 1996;93:2714–8.CrossRefPubMedPubMedCentral
27.
Tiao G, Hobler S, Wang JJ, et al. Sepsis is associated with increased mRNAs of the ubiquitin-proteasome proteolytic pathway in human skeletal muscle. J Clin Invest. 1997;99:163–8.CrossRefPubMedPubMedCentral
28.
Hassen TA, Pearson S, Cowled PA, Fitridge RA. Preoperative nutritional status predicts the severity of the systemic inflammatory response syndrome (SIRS) following major vascular surgery. Eur J Vasc Endovasc Surg. 2007;33:696–702.CrossRefPubMed
29.
Iida Y, Yamada S, Nishida O, Nakamura T. Body mass index is negatively correlated with respiratory muscle weakness and interleukin-6 production after coronary artery bypass grafting. J Crit Care. 2010;25:e1–8.CrossRefPubMed
30.
Plank LD, Connolly AB, Hill GL. Sequential changes in the metabolic response in severely septic patients during the first 23 days after the onset of peritonitis. Ann Surg. 1998;228:146–58.CrossRefPubMedPubMedCentral
31.
Hoffer LJ. Clinical nutrition: 1. Protein-energy malnutrition in the inpatient. Can Med Assoc J.2001;165:1345–9.
32.
33.
Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D, Ross R. Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol. 1998;85:115–22.PubMed
Metadata
Title
Risk Factors for the Loss of Lean Body Mass After Gastrectomy for Gastric Cancer
Authors
Toru Aoyama, MD, PhD
Tsutomu Sato, MD, PhD
Kenki Segami, MD
Yukio Maezawa, MD
Kazuki Kano, MD
Taiichi Kawabe, MD
Hirohito Fujikawa, MD
Tsutomu Hayashi, MD
Takanobu Yamada, MD
Kazuhito Tsuchida, MD
Norio Yukawa, MD, PhD
Takashi Oshima, MD, PhD
Yasushi Rino, MD, PhD
Munetaka Masuda, MD, PhD
Takashi Ogata, MD, PhD
Haruhiko Cho, MD, PhD
Takaki Yoshikawa, MD, PhD
Publication date
01-06-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-5080-4

Other articles of this Issue 6/2016

Annals of Surgical Oncology 6/2016 Go to the issue

Pancreatic Tumors

Elderly Patients Strongly Benefit from Centralization of Pancreatic Cancer Surgery: A Population-Based Study

Melanomas

Magnetic Technique for Sentinel Lymph Node Biopsy in Melanoma: The MELAMAG Trial

Colorectal Cancer

Colorectal Cancer Resections in the Oldest Old Between 2011 and 2012 in The Netherlands

Head and Neck Oncology

Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients

Breast Oncology

Asymptomatic Benign Papilloma Without Atypia Diagnosed at Ultrasonography-Guided 14-Gauge Core Needle Biopsy: Which Subgroup can be Managed by Observation?

Gastrointestinal Oncology

Splenectomy Increases Postoperative Complications Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy