Patterns and Predictors of Weight Loss After Gastrectomy for Cancer

Abstract

Background Weight loss following gastrectomy for patients with gastric cancer has not been well characterized. We assessed the impact of patient and procedure-specific variables on postoperative weight loss following gastrectomy for cancer. Methods A prospectively maintained gastric cancer database identified patients undergoing gastrectomy for cancer. Clinical and pathologic characteristics, baseline body mass index (BMI), and postoperative weights were extracted. Change in weight was analyzed by percent change in weight and absolute change in BMI. Random coefficients models were used to test whether the rate of change in weight over time differed by factors of interest. Results Of 376 consecutive patients who underwent resection for gastric adenocarcinoma, 55 % were male, median age 66 years, and mean preoperative BMI 27.1 (range 16.2–45.6). Total gastrectomy was associated with more weight loss than subtotal gastrectomy at 1 year (15 vs. 6 %, early stage; 17 vs. 7 %, late stage). Maximum weight change was observed at 6–12 months after operation and remained stable or improved at 2 years. For early- and late-stage patients, median percent weight loss at 1 year was greater for BMI ≥ 30 versus BMI < 30 (14 vs. 8 %, early stage; 15 vs. 9 %, late stage). Conclusions The extent of weight loss after gastrectomy for gastric cancer is dependent on preoperative BMI and extent of gastric resection. Maximum weight change is expected by 12 months after operation and will stabilize or improve over time.

Laparoscopic proximal gastrectomy with oblique jejunogastrostomy

“…As to long-term function, changes of serum hemoglobin and body weight after gastrectomy were reported. The present results for body weight loss and decrease in serum hemoglobin were not worse than the body weight loss (14.1 -30.0%) [32][33][34][35][36] and decrease in serum hemoglobin (9.7%) [33] at 12 months after total gastrectomy. Ahn et al [17] first reported 43 cases of DTR after LPG, and they performed a Roux-en-Y esophagojejunostomy by intracorporeal anastomosis with a circular stapler by a minilaparotomy, and side-to-side gastrojejunostomy was performed in an extracorporeal fashion using 2 linear staplers.…”

Should pylorus-preserving gastrectomy be performed for overweight/obese patients with gastric cancer?

“…In this study, overweight/obese patients lost an average of more than 10% of body weight after LPPG; this weight loss was similar to that after LDG. Previous studies have shown that overweight/obese patients tend to lose a higher proportion of body weight than nonoverweight/non-obese patients after standard curative resection of GC, such as distal or total gastrectomy [15,16]. The present study focused on body weight change following a function-preserving procedure, PPG, in which body weight is generally expected to be well maintained.…”

“…In an Asian series, Kong et al [15] found that overweight patients (body mass index [BMI] ≥ 25 kg/m 2 ) were likely to lose excessive body weight and to achieve ideal body weight after curative gastrectomy. In a Western series, Davis et al [16] reported that the extent of weight loss after gastrectomy for GC was associated with preoperative BMI (≥ 30 kg/m 2 versus < 30 kg/m 2 ) as well as extent of gastric resection (total versus subtotal). However, those reports were based on clinical data after standard gastrectomy for GC.…”

Body mass index and mortality in patients with gastric cancer: a large cohort study

“…One-year post-operative BMI was the weight measured between 9 and 15 months after surgery. Post-operative BMI tends to be maintained after 12 months regardless of the type of operation [19].…”