Purpose: The standard treatment for stage IB gastric cancer is curative surgery alone, but some patients show poor survival with disease recurrence after curative surgery. The aim of this study was to identify prognostic factors of recurrence and long-term survival in patients with stage IB gastric cancer after surgery. Materials and Methods: We retrospectively reviewed data from 253 patients with stage IB gastric cancer who underwent gastrectomy between 2011 and 2016 at Kyungpook National University Chilgok Hospital and analyzed the clinicopathological characteristics associated with recurrence and survival. Results: Fourteen patients experienced recurrence with a mean follow-up of 54.1 months. Two of these patients had locoregional recurrence and 12 patients had systemic recurrence. The median interval between the operation day and the day of recurrence was 11 months (range 4-56 months). Multivariate analysis revealed that lymphatic vessel invasion (LVI) (hazard ratio [HR], 3.851; 95% confidence interval [CI], 1.264-11.732) and the elderly (age≥65) (HR, 3.850; 95% CI, 1.157-12.809) were independent risk factors for recurrence after surgery. The LVI (HR, 3.630; 95% CI, 1.105-11.923) was the independent prognostic factors for disease-specific survival (DSS). The 5-year DSS rates were 96.8% in patients who did not have LVI, and 89.3% in patients who had LVI. Conclusions: This study shows that LVI was associated with recurrence and poor survival in patients with stage IB gastric cancer after curative gastrectomy. Patients diagnosed with LVI require careful attention for systemic recurrence during the follow-up period.

Despite progress in cancer treatment, surgical resection is the primary treatment option for advanced gastric cancer. Unlike early stages of gastric cancer, in which function preserving gastrectomy can be performed, distal subtotal gastrectomy or total gastrectomy (TG) is the standard treatment for advanced gastric cancer [1]. However, postgastrectomy symptoms due to surgical resection, which result in loss of reservoir capacity, are inevitable. These postgastrectomy symptoms lead to deterioration in patient quality of life (QoL) and body composition (BC) status and can vary depending on the extent of the gastrectomy [2].Patient survival is always the highest priority in the treatment

Purpose: This study evaluated differences and shifting patterns in the health-related quality of life (HRQoL) of 5-year gastric cancer survivors after either a distal subtotal gastrectomy (DSG) or total gastrectomy (TG). Materials and Methods: We analyzed the prospectively collected HRQoL data of 528 patients who survived 5 years without recurrence using the European Organization for the Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Quality of Life Questionnaire-Stomach module according to the type of surgery. The purpose was to identify the proportion of patients with deteriorating HRQoL and to assess the clinical significance of these changes. Results: Deteriorating HRQoL was prevalent in both groups, including a large proportion of the DSG group. Decreased overall health status and scores on several function scales were less in the DSG group, while increases on the symptom scales were higher in the TG group. For most of the scales, gaps in HRQoL during the early postoperative period did not merge within the 5 years. Scores on the diarrhea and body image scales revealed "moderate changes" in both groups. Conclusions: During the 5-year period after surgery, the TG group suffered from inferior HRQoL compared to the DSG group. However, a large proportion of the DSG group also suffered HRQoL deterioration. In general, the TG group experienced more HRQoL decline, with diarrhea and body image being the major concerns for both groups. To improve HRQoL after gastrectomy, patients must be better informed about post-gastrectomy symptoms. These symptoms must be vigorously investigated, and medical interventions should be available parallel to nutritional support. Favorable evidence of function-preserving gastrectomy should be established and disseminated to improve the HRQoL of early gastric cancer patients.

PurposePhase angle obtained using bioelectrical impedance analysis (BIA) provides a relatively precise assessment of the nutritional status of elderly patients. This study aimed to evaluate the significance of phase angle as a risk factor for complications after gastrectomy in elderly patients.Materials and MethodsWe evaluated 210 elderly patients (aged ≥65 years) who had undergone gastrectomy for gastric cancer between August 2016 and August 2017. The phase angle cutoff value was calculated using receiver operating characteristic curve analysis according to sex. A retrospective analysis regarding the correlation between early postoperative complications and well-known risk factors, including the phase angle, was performed.ResultsMultivariate analysis revealed that the presence of two or more comorbidities (odds ratio [OR], 3.675) and hypoalbuminemia (OR, 4.059) were independent risk factors for overall complications, and female sex (OR, 2.993) was independent risk factor for severe complications. A low phase angle (OR, 2.901 and 4.348, respectively) and total gastrectomy (OR, 4.718 and 3.473, respectively) were independent risk factors for both overall and severe complications.ConclusionsOur findings show that preoperative low phase angle predicts the risk of overall and severe complications. Our findings suggest that BIA should be performed to assess the risk of postoperative complications in elderly patients with gastric cancer.

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Purpose The study aimed to investigate how elderly gastric cancer patients do postoperatively in terms of quality of life (QoL) compared to younger patients. We also investigated how the QoL of elderly gastric cancer patients has changed over the last decade in the aging population. Methods We included 113 elderly (≥70 years) and 202 younger patients, who underwent distal gastrectomy for stage I gastric cancer during the 2010s. The European Organisation for Research and Treatment of Cancer quality of life questionnaires were used to assess preoperative and postoperative (3-month/1-year) QoL. The baseline QoL and postoperative QoL changes were compared. The elderly patients were further grouped into the early- and late-2010s groups, based on the year of surgery, and their QoL and clinical data were compared. Results The baseline QoL was significantly different on some scales (physical/role functionings, and pain/dyspnea/dysphagia) in favor of younger patients. The postoperative QoL changes were not different with the exception of emotional functioning (1-year postoperatively) in favor of younger patients. Compared to the early-2010s group, comorbidities were more frequent, and the proportion of stage IA cancer was higher in the late-2010s group. There were no QoL differences with the exception of insomnia and financial difficulties (3-months postoperatively) in favor of the late-2010s group. Conclusion Despite baseline QoL differences, elderly gastric cancer patients did as well as younger patients in terms of postoperative QoL changes. More elderly gastric cancer patients with comorbidities are undergoing gastrectomies nowadays and it does not cause them a significant QoL disadvantage.