Randomized controlled clinical trial assessing the effects of oral nutritional supplements in postoperative gastric cancer patients

Hatao, Fumihiko; Chen, Kuen‐Yuan; Wu, Jin-Ming; Wang, Mingyang; Aikou, Susumu; Onoyama, Haruna; Shimizu, Nobuyuki; Fukatsu, Kazuhiko; Seto, Yasuyuki; Lin, Jaw–Town

doi:10.1007/s00423-016-1527-8

Cited by 54 publications

(53 citation statements)

References 22 publications

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“…Clarifying the mechanisms of sarcopenia in patients with cancer may help reveal the mechanism of cachexia, the root of cancer death. Previous studies have shown that various methods of nutritional support are effective for improving dietary intake and outcomes in patients who lose weight after surgery (21,22). Hatao et al found that the use of oral nutritional supplements after total gastrectomy significantly diminished postoperative weight loss (21).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that various methods of nutritional support are effective for improving dietary intake and outcomes in patients who lose weight after surgery (21,22). Hatao et al found that the use of oral nutritional supplements after total gastrectomy significantly diminished postoperative weight loss (21). If oral nutritional supplements can be demonstrated to also be efficacious for preventing postoperative muscle mass reduction, such oral nutritional supplements could consequently be administered to patients with sarcopenia, which is an especially common finding after total gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

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Loss of skeletal muscle mass after curative gastrectomy is a poor prognostic factor

et al. 2018

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Sarcopenia has been reported to relate to poor prognosis in various malignant cancer types. The present study aimed to clarify the prognostic impact of skeletal muscle mass (SMM) loss after curative gastrectomy in patients with gastric cancer. A total of 119 patients who underwent curative gastrectomy for gastric cancer between 2009 and 2016 were analyzed. The SMM loss at 6 months postoperatively compared with the SMM prior to surgery was calculated using the hospital records. The median loss of SMM was 3.8%. Multivariate logistic regression analysis demonstrated that total gastrectomy was a significant and independent risk factor for SMM loss of ≥5% (odds ratio=2.58; P=0.02). Results from multivariate analysis using stepwise Cox proportional hazards regression indicated that the following factors were significantly associated with shorter overall survival after curative gastrectomy: Age [>70 years; hazard ratio (HR)=2.46, P=0.04], TNM stage (≥2; HR=2.65, P=0.04) and loss of SMM (≥5%; HR=2.57, P=0.03). The present findings suggested that loss of SMM after curative gastrectomy for gastric cancer is an independent predictive factor for poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Loss of skeletal muscle mass after curative gastrectomy is a poor prognostic factor

et al. 2018

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“…Hatao et al investigated the effects of ONS on postoperative body weight loss in patients with gastric cancer who had undergone total gastrectomy or distal gastrectomy (24). In their study, although weight loss in the ONS group after total gastrectomy was significantly less than that in the control group, the weight loss and skeletal muscle mass loss after distal gastrectomy did not significantly differ between the groups.…”

Section: Gradementioning

confidence: 99%

Comparison of Weight and Body Composition After Gastrectomy Between Elderly and Non-elderly Patients With Gastric Cancer

Aoyama

Maezawa

Yoshikawa

et al. 2018

In Vivo

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Background: Body weight, especially lean body mass, significantly decreases after gastrectomy for gastric cancer due to surgical invasion, reduced food intake, and reduced mobility, which can reduce the quality of life and induce associated toxicity or reduce compliance with adjuvant chemotherapy. Such risks can be particularly high in elderly patients with gastric cancer. However, whether or not changes in the weight and body composition differ between elderly and non-elderly patients remains unclear. Patients and Methods: This retrospective study examined patients who underwent curative surgery for gastric cancer between May 2010 and February 2017. Body weight and composition were evaluated by a bioelectrical impedance analyzer within 1 week before surgery, at 1 week after surgery, and at 1 and at 3 months after surgery. Patients were classified as elderly (≥80 years) or non-elderly (<80 years). Results: Eight-hundred and eighty-eight patients (84 elderly and 804 non-elderly) were entered into the present study. Patient background, surgical and clinicopathological factors, and surgical complications did not significantly differ between the two groups.

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“…To our knowledge, malnutrition is a common presentation in GA patients due to cancer cachexia and the obstruction of gastrointestinal tract. For the surgical patients, the increased physical metabolism and insufficient calorie intake further deteriorate the metabolism balance, which causes minor (fatigue or delayed recovery) or major adverse effects (complication or mortality) [50]. Therefore, preoperative screening is very imperative to recognize the malnourished patients, who need nutrition intervention program [51].…”

Section: Discussionmentioning

confidence: 99%

Association between Interleukin-6 Levels and Perioperative Fatigue in Gastric Adenocarcinoma Patients

Yang

et al. 2019

JCM

Self Cite

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Background: Gastric adenocarcinoma (GA), one of the most common gastrointestinal cancers worldwide, is often accompanied by cancer cachexia in the advanced stage owing to malnutrition and cancer-related symptoms. Although resection is the most effective curative procedure for GA patients, it may cause perioperative fatigue, worsening the extent of cancer cachexia. Although the relationship between cytokines and cancer fatigue has been evaluated, it is unclear which cytokines are associated with fatigue in GA patients. Therefore, this study aimed to investigate whether the changes in cytokine levels were associated with the perioperative changes in fatigue amongst GA patients. Methods: We included GA patients undergoing gastric surgery in a single academic medical center between June 2017 and December 2018. Fatigue-related questionnaires, serum cytokine levels (interferon-gamma, interleukin (IL)-1, IL-2, IL-5, IL-6, IL-12 p70, tumor necrosis factor-alpha, and granulocyte-macrophage colony-stimulating factor), and biochemistry profiles (albumin, prealbumin, C-reactive protein, and white blood cell counts) were assessed at three time points (preoperative day 0 (POD 0), post-operative day 1 (POD 1), and postoperative day 7 (POD 7)). We used the Brief Fatigue Inventory-Taiwan Form to assess the extent of fatigue. The change in fatigue scores among the three time points, as an independent variable, was adjusted for clinicopathologic characteristics, malnutrition risk, and cancer stages. Results: A total of 34 patients were included for analysis, including 12 female and 22 male patients. The mean age was 68.9 years. The mean score for fatigue on POD 0, POD 1, and POD 7 was 1.7, 6.2, and 3.6, respectively, with significant differences among the three time points (P < 0.001). Among the cytokines, only IL-6 was significantly elevated from POD 0 to POD 1. In the regression model, the change in IL-6 levels between POD 0 and POD 1 (coefficients = 0.01 for every 1 pg/mL increment; 95% confidence interval: 0.01–0.02; P = 0.037) and high malnutrition risk (coefficients = 2.80; 95% confidence interval: 1.45–3.52; P = 0.041) were significantly associated with changes in fatigue scores. Conclusions: The perioperative changes in plasma IL-6 levels are positively associated with changes in the fatigue scores of GA patients undergoing gastric surgery. Targeting the IL-6 signaling cascade or new fatigue-targeting medications may attenuate perioperative fatigue, and further clinical studies should be designed to validate this hypothesis.

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Randomized controlled clinical trial assessing the effects of oral nutritional supplements in postoperative gastric cancer patients

Abstract: This study showed ONS after total gastrectomy to significantly diminish postoperative weight loss.

Cited by 54 publications

References 22 publications

Loss of skeletal muscle mass after curative gastrectomy is a poor prognostic factor

Loss of skeletal muscle mass after curative gastrectomy is a poor prognostic factor

Comparison of Weight and Body Composition After Gastrectomy Between Elderly and Non-elderly Patients With Gastric Cancer

Association between Interleukin-6 Levels and Perioperative Fatigue in Gastric Adenocarcinoma Patients

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