Impact of body mass index on quality of life after distal gastrectomy for gastric cancer

Abstract

Purpose Few studies have evaluated changes in quality of life (QoL) in relation to changes in body mass index (BMI) after gastrectomy. This study aimed to evaluate the impact of postoperative changes in BMI on QoL after distal gastrectomy in gastric cancer patients. Methods QoL data from the European Organization for the Research and Treatment of Cancer (EORTC) gathered via the QLQ-C30 and QLQ-STO22 questionnaires were obtained from 1,036 patients preoperatively and at 1 year postoperatively. The patients were divided into 2 groups: group 1 - decreased postoperative BMI and group 2 - unchanged or increased postoperative BMI. Results There were 577 patients in group 1 and 459 in group 2. According to global health status and functional scales, emotional functioning (P = 0.035) was significantly worse in group 1 than in group 2 at 1 year postoperatively. Furthermore, there were significant decreases in QoL symptom scale scores, including fatigue (P = 0.016), nausea and vomiting (P = 0.002), and appetite loss (P = 0.001) scores, in group 1 compared with group 2. Regarding QLQ-STO22, reflux symptoms (P = 0.020), anxiety (P = 0.003), and body image (P = 0.003) were significantly worse in group 1 than in group 2 at 1 year after surgery. Conclusion BMI changes after distal gastrectomy influence QoL. Focus on controlling gastrointestinal symptoms and providing psychological support is essential in patients with decreased BMI after surgery. Patients should be offered follow-up care to assist them in maintaining BMI, for example, through dietary-behavior modifications and via intensive nutritional support, to prevent QoL deterioration after distal gastrectomy.

Chronological changes in quality of life and body composition after gastrectomy for locally advanced gastric cancer

“…Many studies have been conducted on the QoL and altered BC of patients after gastrectomy. However, most studies focus on the QoL or BC that has changed after surgery rather than investigating the medical interventions that can be administered to the patient [14][15][16]. Also, in practice, it is not an easy process to significantly improve QoL and BC changes during postoperative follow-up.…”

Health-Related Quality of Life in Patients With Locally Advanced Gastric Cancer Undergoing Perioperative or Postoperative Adjuvant S-1 Plus Oxaliplatin With D2 Gastrectomy: A Propensity Score-Matched Cohort Study

“…Seven patients in the peri-SOX and eighteen patients in the post-SOX group were unwilling to respond to the questionnaires at least twice, even if they had completed the indicated cycles of chemotherapy. The baseline characteristics of these two arms were comparable except for BMI ( p = 0.032) and clinical nodal stage ( p = 0.025), which were reported to affect the HRQOL of cancer patients, and acted as potential confounders in this study ( 58 – 61 ). After PSM, baseline characteristics were evenly distributed between the peri-SOX and post-SOX groups, with 45 patients in each group ( Table 1 ).…”

Factors connected with anxiety and other neuropsychiatric symptoms in advanced gastric cancer

“…Our observations show a correlation between the occurrence of weight loss above 10% and the occurrence of anxiety. Weight loss is a common problem in patients with gastric cancer, affecting up to half of the patients at the time of cancer diagnosis (Soleyman-Jahi et al, 2017) Muscle tissue catabolism and weight reduction have a negative impact on patient self-esteem and anxiety (Park et al, 2019) Reduced self-esteem increases the risk of depressive conditions (Park et al, 2018). A bad mental state reduces appetite and increases weight loss on the basis of a vicious circle.…”