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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-05-2016 | Gastrointestinal Oncology

Patterns and Predictors of Weight Loss After Gastrectomy for Cancer

Authors: Jeremy L. Davis, MD, Luke V. Selby, MD, Joanne F. Chou, MPH, Mark Schattner, MD, David H. Ilson, MD, PhD, Marinela Capanu, PhD, Murray F. Brennan, MD, Daniel G. Coit, MD, Vivian E. Strong, MD

Published in: Annals of Surgical Oncology | Issue 5/2016

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Abstract

Background

Weight loss following gastrectomy for patients with gastric cancer has not been well characterized. We assessed the impact of patient and procedure-specific variables on postoperative weight loss following gastrectomy for cancer.

Methods

A prospectively maintained gastric cancer database identified patients undergoing gastrectomy for cancer. Clinical and pathologic characteristics, baseline body mass index (BMI), and postoperative weights were extracted. Change in weight was analyzed by percent change in weight and absolute change in BMI. Random coefficients models were used to test whether the rate of change in weight over time differed by factors of interest.

Results

Of 376 consecutive patients who underwent resection for gastric adenocarcinoma, 55 % were male, median age 66 years, and mean preoperative BMI 27.1 (range 16.2–45.6). Total gastrectomy was associated with more weight loss than subtotal gastrectomy at 1 year (15 vs. 6 %, early stage; 17 vs. 7 %, late stage). Maximum weight change was observed at 6–12 months after operation and remained stable or improved at 2 years. For early- and late-stage patients, median percent weight loss at 1 year was greater for BMI ≥ 30 versus BMI < 30 (14 vs. 8 %, early stage; 15 vs. 9 %, late stage).

Conclusions

The extent of weight loss after gastrectomy for gastric cancer is dependent on preoperative BMI and extent of gastric resection. Maximum weight change is expected by 12 months after operation and will stabilize or improve over time.
Literature
1.
2.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 2013; http://​globocan.​iarc.​fr. Accessed 1 Dec 2013.
3.
Brennan MF, Pisters PW, Posner M, Quesada O, Shike M. A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy. Ann Surg. 1994;220(4):436–41; discussion 441–4.CrossRefPubMedPubMedCentral
4.
Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Ann Surg. 1997;226(4):567–77; discussion 577–80CrossRefPubMedPubMedCentral
5.
Hur H, Kim SG, Shim JH, et al. Effect of early oral feeding after gastric cancer surgery: a result of randomized clinical trial. Surgery. 2011;149(4):561–8.CrossRefPubMed
6.
7.
Aoyama T, Yoshikawa T, Shirai J, et al. Body weight loss after surgery is an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol. 2013;20(6):2000–6.CrossRefPubMed
8.
Lee SE, Lee JH, Ryu KW, et al. Changing pattern of postoperative body weight and its association with recurrence and survival after curative resection for gastric cancer. Hepatogastroenterology. 2012;59(114):430–5.CrossRefPubMed
9.
Bickenbach KA, Denton B, Gonen M, Brennan MF, Coit DG, Strong VE. Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer. Ann Surg Oncol. 2013;20(3):780–7.CrossRefPubMed
10.
Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.CrossRefPubMed
11.
Littell RC, Milliken GA, Stroup WW, Wolfinger RD, Schabenberger O. SAS® for Mixed Models. 2nd ed. Cary: SAS Institute Inc; 2006.
12.
Selby LV, Vertosick EA, Sjoberg DD, et al. Morbidity after total gastrectomy: analysis of 238 patients. J Am Coll Surg. 2015;220(5):863–71.e2.CrossRef
13.
Hirao M, Takiguchi S, Imamura H, et al. Comparison of Billroth I and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer: one-year postoperative effects assessed by a multi-institutional RCT. Ann Surg Oncol. 2013;20(5):1591–7.CrossRefPubMed
14.
Fein M, Fuchs KH, Thalheimer A, Freys SM, Heimbucher J, Thiede A. Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a randomized trial. Ann Surg. 2008;247(5):759–65.CrossRefPubMed
15.
Sierzega M, Choruz R, Pietruszka S, Kulig P, Kolodziejczyk P, Kulig J. Feasibility and outcomes of early oral feeding after total gastrectomy for cancer. J Gastrointest Surg. 2015;19(3):473–9CrossRefPubMedPubMedCentral
16.
Patel SH, Kooby DA, Staley CA, 3rd, Maithel SK. An assessment of feeding jejunostomy tube placement at the time of resection for gastric adenocarcinoma. J Surg Oncol. 2013;107(7):728–34.CrossRefPubMed
Metadata
Title
Patterns and Predictors of Weight Loss After Gastrectomy for Cancer
Authors
Jeremy L. Davis, MD
Luke V. Selby, MD
Joanne F. Chou, MPH
Mark Schattner, MD
David H. Ilson, MD, PhD
Marinela Capanu, PhD
Murray F. Brennan, MD
Daniel G. Coit, MD
Vivian E. Strong, MD
Publication date
01-05-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-5065-3

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