Risk factors for severe weight loss after gastrectomy for gastric cancer.

Authors

null

Kenki Segami

Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan

Kenki Segami , Toru Aoyama , Taiichi Kawabe , Shigeya Hayashi , Yousuke Makuuchi , Tsutomu Sato , Takanobu Yamada , Tsutomu Hayashi , Hirohito Fujikawa , Yasushi Rino , Munetaka Masuda , Takashi Ogata , Haruhiko Cho , Takaki Yoshikawa

Organizations

Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan, Kanagawa Cancer Center, Yokohama, Japan, Department of Gastroenterological Surgery, Kanagawa Cancer Center, Yokohama, Japan, Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama-shi, Japan, Yokohama City University, Yokohama, Japan, Department of Surgery, Yokohama City University, Yokohama, Japan

Research Funding

No funding sources reported

Background: Body weight loss (BWL) is frequently observed in gastric cancer patients who underwent gastrectomy for gastric cancer. Recently, we reported that severe BWL after gastrectomy was a significant risk factor for continuation of S-1 adjuvant chemotherapy. However, risk factors of BWL after surgery remain unclear. Methods: The present study retrospectively examined the patients who electively underwent curative gastrectomy for gastric cancer between January of 2012 and June of 2014. All patients received peri-operative care of ERAS protocol. %BWL was calculated by percentile of body weight at one month after surgery to preoperative body weight. Severe BWL was defined as %BWL over 10%. Risk factors for severe BWL were determined by both univariate and multivariate logistic regression analyses. Results: Two-hundred seventy eight patients were examined. Median age (range) was 68 years (27-86). Median body mass index (range) was 22 (13.4-33.5). Thirty patients had received neoadjuvant chemotherapy. Operative procedure was total gastrectomy (TG) in 97 patients (Open in 61 and laparoscopic in 36) and distal gastrectomy (DG) in 181 patients (Open in 94 and laparoscopic in 87). Median operation time (range) was 268.5 minutes (95-554). Median blood loss (range) was 115 mL (0-1600). Morbidity of grade 2 or more defined by Clavien-Dindo classification was observed in 37 patients including pancreatic fistula in 8, anastomotic leakage in 5, and abdominal abscess in 3. No mortality was found. Completion of ERAS protocol without any variance was 95.3%. Median %BWL was 6% (-4.3% to 19.5%). Both univariate and multivariate logistic analyses demonstrated that morbidity (odds rate 3.56, p=0.001), blood loss over 300ml (odds rate 2.04, p=0.0356), and total gastrectomy (odds rate 2.1, p=0.0258) were significant risk factors for severe BWL. Conclusions: Nutritional intervention trial to inhibit BWL after gastrectomy should be focused on the patients who developed morbidity, showed blood loss over 300ml, or received total gastrectomy.

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Abstract Details

Meeting

2015 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

General Poster Session A: Cancers of the Esophagus and Stomach

Track

Cancers of the Esophagus and Stomach

Sub Track

Prevention, Diagnosis, and Screening

Citation

J Clin Oncol 33, 2015 (suppl 3; abstr 38)

DOI

10.1200/jco.2015.33.3_suppl.38

Abstract #

38

Poster Bd #

A38

Abstract Disclosures

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