J Gastric Cancer.  2017 Jun;17(2):99-109. 10.5230/jgc.2017.17.e12.

Actual 5-Year Nutritional Outcomes of Patients with Gastric Cancer

• Kim KH
• Park DJ
• Park YS
• Ahn SH
• Park DJ
• Kim HH

• KMID: 2383733
• DOI: http://doi.org/10.5230/jgc.2017.17.e12

Abstract

PURPOSE
In this study, we aimed to evaluate the rarely reported long-term nutritional results of patients with gastric cancer after curative gastrectomy.
MATERIALS AND METHODS
We retrospectively reviewed the prospectively collected medical records of 658 patients who underwent radical gastrectomy with curative intent for gastric cancer from January 2008 to December 2009 and had no recurrences. All patients were followed for 5 years. Nutritional statuses were assessed using measurements of body weight, serum hemoglobin, total lymphocyte count (TLC), protein, albumin, cholesterol, and nutritional risk index (NRI).
RESULTS
Patients who underwent total gastrectomy had lower body weights, hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued after the first postoperative year (P<0.05), and lower hemoglobin and NRI valued during the fifth postoperative year than patients who underwent distal gastrectomy (P<0.05). Patients who received adjuvant chemotherapy after gastrectomy had lower hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued during the first postoperative year, than those who underwent gastrectomy only (P<0.05). Regarding post-distal gastrectomy reconstruction, those who underwent Roux-en-Y had lower cholesterol levels than did those who underwent Billroth-I and Billroth-II reconstruction at the first and fifth years after gastrectomy, respectively (P<0.05).
CONCLUSIONS
Patients undergoing total or distal gastrectomy with Roux-en-Y anastomosis or adjuvant chemotherapy after surgery should be monitored carefully for malnutrition during the first postoperative year, and patients undergoing total gastrectomy should be monitored for malnutrition and anemia for 5 years.

Keyword

Stomach neoplasms; Nutrition status; Nutritional risk index

MeSH Terms

Anastomosis, Roux-en-Y
Anemia
Body Weight
Chemotherapy, Adjuvant
Cholesterol
Gastrectomy
Humans
Lymphocyte Count
Malnutrition
Medical Records
Nutritional Status
Prospective Studies
Recurrence
Retrospective Studies
Stomach Neoplasms*
Cholesterol

Figure

• 

  Fig. 1 Incidence of anemia and malnutrition 1–5 years postoperatively among patients who underwent total or distal gastrectomy (A and B) or did or did not undergo chemotherapy (C and D). Anemia was defined as a hemoglobin levels <12 g/dL for women or <13 g/dL for men. Malnutrition was defined as a NRI of <97.5. NRI was calculated using the following formula: 1.519×serum albumin (g/L)+0.417×(present weight/usual weight×100). Preop. = preoperative; NRI = nutritional risk index. *P<0.05, as determined by the χ2 test.

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