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

• Published in: Annals of surgical oncology Vol. 23; no. 6; pp. 1963 - 1970
• Main Authors: Aoyama, Toru, Sato, Tsutomu, Segami, Kenki, Maezawa, Yukio, Kano, Kazuki, Kawabe, Taiichi, Fujikawa, Hirohito, Hayashi, Tsutomu, Yamada, Takanobu, Tsuchida, Kazuhito, Yukawa, Norio, Oshima, Takashi, Rino, Yasushi, Masuda, Munetaka, Ogata, Takashi, Cho, Haruhiko, Yoshikawa, Takaki
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2016; Springer Nature B.V
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Body Fat Distribution; Female; Follow-Up Studies; Gastrectomy - adverse effects; Gastrointestinal Oncology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Postoperative Complications; Prognosis; Prospective Studies; Retrospective Studies; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery; Surgical Oncology; Weight Loss; Gastric Cancer; Enteral Nutrition; Gastric Cancer Patient; Lean Body Mass; Total Gastrectomy
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-015-5080-4

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.