Body Weight Loss After Surgery is an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer

Aoyama, Toru; Yoshikawa, Takaki; Shirai, Junya; Hayashi, Tsutomu; Yamada, Takanobu; Tsuchida, Kazuhito; Hasegawa, Shin; Cho, Haruhiko; Yukawa, Norio; Oshima, Takashi; Rino, Yasushi; Masuda, Munetaka; Tsuburaya, Akira

doi:10.1245/s10434-012-2776-6

Cited by 141 publications

(83 citation statements)

References 16 publications

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“…In the present prospective study, the ratio of postoperative to preoperative body weight was significantly higher at both 1 week postoperatively and 1 month postoperatively in the ERAS protocol group than in the conventional protocol group. Some investigators have reported that body weight loss at 1 month after surgery is a significant risk factor for continuation of adjuvant chemotherapy with S-1 [35]. Therefore, attenuation of body weight loss by use of the ERAS protocol might lead to improved adherence to adjuvant chemotherapy, which might help to prolong overall survival for patients with gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

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Protocol for enhanced recovery after surgery improves short-term outcomes for patients with gastric cancer: a randomized clinical trial

et al. 2017

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Background The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear. Methods This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity. Results From July 2013 to June 2015, we randomized 148 patients into an ERAS protocol group (n = 73) and a conventional protocol group (n = 69); six patients withdrew from the study. The hospital stay was significantly shorter in the ERAS protocol group than in the conventional protocol group (9 days vs 10 days; P = 0.037). The ERAS protocol group had a significantly lower rate of postoperative complications of grade III or higher (4.1% vs 15.4%; P = 0.042) and reduced costs of hospitalization (JPY 1,462,766 vs JPY 1,493,930; P = 0.045). The ratio of body weight to preoperative weight at 1 week and 1 month after the operation was higher in the ERAS protocol group (0.962 vs 0.957, P = 0.020, and 0.951 vs 0.937, P = 0.021, respectively). The ERAS protocol group recorded more physical activity in the first week after surgery.Conclusions The ERAS protocol is safe and efficient, and seems to improve the postoperative course of patients with gastric cancer.

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Section: Discussionmentioning

confidence: 99%

“…The goal of ERAS should be debated. Several researchers have considered the loss of body weight or lean body mass to be more reflective of patients' health status, quality of life, and physical activity [35,38,39].…”

Section: Discussionmentioning

confidence: 99%

Protocol for enhanced recovery after surgery improves short-term outcomes for patients with gastric cancer: a randomized clinical trial

et al. 2017

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“…Because patients who undergo D2 gastrectomy followed by postoperative chemotherapy often have inadequate nutritional intake, resulting in postoperative chemotherapy with insufficient dose intensity 9 , so neoadjuvant chemotherapy (NAC) is an alternative and promising strategy for high risk gastric cancers such as type IV or large type III gastric cancer 10 .…”

Section: Introductionmentioning

confidence: 99%

Lauren Histology and Lymphatic Permeation are Critical Prognostic Factors in Borrmann Type I Gastric Cancer

Yamashita

Katada

Hosoda

et al. 2018

International Surgery

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“…However, 30.6% of patients undergo cancer recurrences, 65.8% continue their S-1 treatments for a full year and 46.5% of patients are administered reduced doses of their recommended regimens (2,3). The clinical parameters for continuing S-1 ACT in these patients has been the focus of several studies (4)(5)(6), as has the role of S-1 dose intensity in ACT subsequent to curative gastrectomy for advanced GC (7). However, the association between relative dose intensity or continuation of S-1 and patient survival has not been fully characterized.…”

Section: Introductionmentioning

confidence: 99%

Outcome predictors for patients with stage II/III gastric cancer who undergo gastrectomy and S-1 adjuvant chemotherapy

et al. 2017

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Abstract. Predictors of survival in patients with stage II/III gastric cancer (GC) who received tegafur/gimeracil/oteracil (S-1) adjuvant chemotherapy (ACT) subsequent to gastrectomy were examined. Additionally, the association between dose intensity of S-1 and survival rate was investigated. A total of 62 patients with stage II/III gastric cancer were retrospectively evaluated, each of whom had received a curative D2 gastrectomy and S-1 ACT. The relative performance (RP; administered/planned S-1 doses x100%), body mass index (BMI), prognostic nutritional index (PNI) and body weight (BW) were calculated, and the association of survival with these factors and other clinicopathological parameters was examined. The 1-year treatment continuation rate for S-1 was 94.2%, excluding patients who experienced cancer recurrences during their ACT year. The initial S-1 reduction rate was 38.7%. Patients with stage II/IIIA disease exhibited significantly improved 5-year overall survival rates compared with patients with stage IIIB GC, 81.6/73.7 vs. 33.8% (P<0.01). No association between RP and survival was observed. BMI, BW and PNI were significantly decreased following surgery compared with preoperative states. In the univariate analysis, postoperative BW loss (BMI loss), pathological stage and >7 lymph node metastases were significantly associated with outcome (P<0.05); in the multivariate analysis, postoperative BW loss >10.6% and pathological stages were independent prognostic factors for survival. Continuing S-1 ACT for the full year exhibited a greater effect on survival compared with dosage. Early postoperative nutritional deterioration may decrease the survival rates in these patients.

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Body Weight Loss After Surgery is an Independent Risk Factor for Continuation of S-1 Adjuvant Chemotherapy for Gastric Cancer

Cited by 141 publications

References 16 publications

Protocol for enhanced recovery after surgery improves short-term outcomes for patients with gastric cancer: a randomized clinical trial

Protocol for enhanced recovery after surgery improves short-term outcomes for patients with gastric cancer: a randomized clinical trial

Lauren Histology and Lymphatic Permeation are Critical Prognostic Factors in Borrmann Type I Gastric Cancer

Outcome predictors for patients with stage II/III gastric cancer who undergo gastrectomy and S-1 adjuvant chemotherapy

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