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Zuo L, Lin J, Ge S, Wu R, Liu B, Cheng Y, Tian Y. Preoperative visceral fat index predicts the survival outcomes of patients with gastric cancer after surgery. Oncol Lett 2024; 27:99. [PMID: 38298425 PMCID: PMC10829067 DOI: 10.3892/ol.2024.14233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/27/2023] [Indexed: 02/02/2024] Open
Abstract
Visceral adipose tissue and skeletal muscle mass are associated with carcinogenesis and clinical outcomes in patients with cancer. The aim of the present study was to determine the influence of body composition parameters on postoperative survival in patients with gastric cancer. Demographic data and systemic inflammatory response data were obtained from patients with gastric cancer undergoing radical gastrectomy. The patient's skeletal muscle and visceral fat were assessed using computed tomography, and the corresponding skeletal muscle index (SMI) and visceral fat index (VFI) were calculated. Univariate and multivariate analyses were then performed. Of the 342 patients from whom information was collected, 125 of these patients eventually succumbed to the disease. A total of 271 (79.24%) of the patients were male and 71 (20.76%) were female. Regarding the entire cohort, the mean age was 64 years [interquartile range (IQR), 56-74 years], while the mean body mass index collected was 21.53 (IQR, 19.27-24.22). The median SMI and VFI of the patients were 47.73 (IQR, 41.67-55.51) and 41.28 (IQR, 36.62-45.36), respectively. It was concluded that a low SMI and VFI were associated with worse survival outcomes. However, the neutrophil-to-lymphocyte ratio and perioperative blood transfusion were not significantly associated with overall survival (OS). Among the indicators assessed, a low VFI was an independent risk factor associated with the worst OS time (hazard ratio 1.59; confidence interval, 1.03-2.45; P=0.038). Finally, a prognostic nomogram was constructed which included the VFI to assist clinicians in making more informed decisions. In conclusion, after data collection and analysis, it was found that there was a significant correlation between a low VFI and a shorter OS time in patients with gastric cancer following gastrectomy, suggesting that VFI may be a promising therapeutic target for postoperative interventions to improve patient survival further.
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Affiliation(s)
- Lugen Zuo
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Jianxiu Lin
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P.R. China
| | - Sitang Ge
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Rong Wu
- Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing, Jiangsu 210000, P.R. China
| | - Baoxinzi Liu
- Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine and Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Ying Cheng
- Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine and Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Yun Tian
- Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine and Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
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Glucose variability and predicted cardiovascular risk after gastrectomy. Surg Today 2022; 52:1634-1644. [PMID: 35357573 DOI: 10.1007/s00595-022-02496-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/27/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the correlation between glycemic trends and cardiovascular risk after gastrectomy for gastric cancer. METHODS We enrolled 105 gastric cancer patients who underwent gastrectomy at our hospital between October 2017 and July 2020. Postoperative glucose concentrations, trends, and patterns were recorded using a continuous glucose monitoring (CGM) device. Cardiovascular risk was calculated using the Framingham stroke risk profile score (FSRPS), the Framingham risk score (FRS), and the Suita score. We examined the correlations between glycemic variability and cardiovascular risk scores. RESULTS There were significant differences in the standard deviation (SD) of glucose levels between the high and low FSRPS groups (p = 0.049), the high and low FRS groups (p = 0.011), and the high and low Suita score groups (p = 0.044). The SD of glucose levels was significantly higher in patients with diabetes mellitus (DM) (p < 0.001) and those who underwent total gastrectomy (TG) (p = 0.017). Additionally, the CGM data available for 38 patients 1 year post-gastrectomy were analyzed for glucose level dynamics, and the SD was found to be significantly higher than that at 1 month (p < 0.001). CONCLUSION Our findings suggest that long-term follow-up and therapeutic strategies tailored to glycemic trends may be necessary for gastric cancer patients after gastrectomy, especially those with DM and those who have undergone TG, to prevent cardiovascular events.
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Kim BR, Lee DH, Shim HI, Kim JW, Park S, Shin CM, Han K, Youn SW. Risk of Psoriasis in Postgastrectomy Gastric Cancer Survivors: A Nationwide Population-Based Cohort Study. Ann Dermatol 2022; 34:191-199. [PMID: 35721330 PMCID: PMC9171185 DOI: 10.5021/ad.2022.34.3.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/28/2021] [Accepted: 01/24/2022] [Indexed: 12/24/2022] Open
Abstract
Background Although patients with psoriasis have an increased risk of cancers, little is known about the risk of psoriasis in cancer patients. Objective We aimed to comparatively analyze the incidence and risk factors of psoriasis in gastric cancer patients who underwent gastrectomy and in the general population. Methods A nationwide retrospective cohort of 52,608 gastric cancer survivors (2007~2015) was compared to 123,438 matched controls from the general population to estimate the incidence and hazard ratio (HR) of new-onset psoriasis. We also calculated the HRs for psoriasis according to adjuvant cancer treatment, obesity, and vitamin B12 supplementation in gastric cancer survivors. Results During a mean follow-up of 6.85 years, 645 of the 52,608 gastric cancer patients developed psoriasis, while 1,806 in the 123,438 matched control group developed psoriasis. Gastric cancer patients had a decreased risk of psoriasis (HR, 0.86; 95% confidence interval, 0.79~0.94), especially those who underwent subtotal gastrectomy. We found that vitamin B12 supplementation for more than 3 years had an additive effect on decreasing the risk of psoriasis in gastric cancer patients who underwent subtotal gastrectomy. Total gastrectomy, radio/chemotherapy, and obesity did not affect the risk of psoriasis in gastric cancer survivors. Conclusion The incidence of psoriasis is slightly lower in gastric cancer survivors than in the general population. Our results suggest that the development of psoriasis may be reduced by removing the source of systemic inflammation caused by Helicobacter pylori infection through subtotal gastrectomy in gastric cancer survivors.
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Affiliation(s)
- Bo Ri Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyun Ik Shim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jee Woo Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sanghyun Park
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Kim YN, Choi YY, An JY, Choi MG, Lee JH, Sohn TS, Bae JM, Noh SH, Kim S. Comparison of Postoperative Nutritional Status after Distal Gastrectomy for Gastric Cancer Using Three Reconstructive Methods: a Multicenter Study of over 1300 Patients. J Gastrointest Surg 2020; 24:1482-1488. [PMID: 31309380 DOI: 10.1007/s11605-019-04301-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 05/02/2019] [Indexed: 01/31/2023]
Abstract
PURPOSE Perioperative nutritional status has been reported to be associated with short- and long-term outcomes after surgery in gastric cancer patients. This study compared changes in nutritional status after distal gastrectomy using the Billroth I (BI), Billroth II (BII), and Roux-en-Y (RY) reconstruction techniques in gastric cancer patients. MATERIALS AND METHODS Data from 1305 gastric cancer patients who underwent distal gastrectomy at two tertiary hospitals from January 2011 to December 2016 were reviewed. The patients were divided into three groups according to reconstruction type: BI, BII, and RY. We evaluated changes in nutritional parameters including body mass index (BMI), biochemical data, the prognostic nutritional index (PNI), nutritional risk index (NRI), and geriatric nutritional risk index (GNRI) preoperatively, and 3, 6, and 12 months after surgery. RESULTS Total protein, albumin, PNI, and NRI were significantly lower in the BII group than in the BI and RY groups during follow-up (P < 0.001). In multivariate analysis, reconstruction types were independently related to decreases in BMI (> 10%), low serum protein, albumin, and cholesterol 12 months after surgery. Compared with BI, BII was associated with decreased BMI, low protein, and albumin and RY was associated with decreased BMI and low cholesterol. CONCLUSION During the first year after gastric cancer surgery, postoperative nutritional status differed according to the reconstruction type; BI resulted in the least weight and nutritional loss, RY yielded results comparable with BI in the nutritional indexes, and BII resulted in the greatest nutritional loss.
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Affiliation(s)
- You Na Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.,Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoon Young Choi
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Yeong An
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Min-Gew Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jae Moon Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Sung Hoon Noh
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
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Increased Risk of Osteoporotic Fracture in Postgastrectomy Gastric Cancer Survivors Compared With Matched Controls: A Nationwide Cohort Study in Korea. Am J Gastroenterol 2019; 114:1735-1743. [PMID: 31658122 DOI: 10.14309/ajg.0000000000000436] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Gastrectomy can lead to bone loss. Previous studies have suggested that there is an increased risk of fracture in gastric cancer survivors. However, these studies were performed without proper control groups. Therefore, we used Korean national health insurance data to compare the fracture risk in gastric cancer survivors who received gastrectomy to that of the general population. METHODS A total of 133,179 gastric cancer survivors were included and matched to noncancer controls using 1:1 propensity score matching. Cox proportional hazards regression analysis was used to determine the relative risk of fracture between the gastric cancer survivors and matched controls. We also examined the factors associated with fracture in gastric cancer survivors. RESULTS Compared with the matched controls, gastric cancer survivors had an elevated risk of osteoporotic fracture (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.53-1.70), which was most prominent in patients who underwent total gastrectomy (HR 2.18, 95% CI 1.96-2.44) and adjuvant chemotherapy (HR 2.01, 95% CI 1.81-2.23). In multivariate analysis, anemia was significantly associated with increased fracture risk (aHR 1.34, 95% CI 1.13-1.59), while decrease in weight >5% was not (aHR 1.06, 95% CI 0.89-1.25). DISCUSSION Gastric cancer survivors who underwent gastrectomy had an increased osteoporotic fracture risk than did matched controls. Total gastrectomy, adjuvant chemotherapy, and anemia were associated with an even higher risk in these patients. Additional studies are needed to establish optimal strategies, such as screening for osteoporosis and preventive interventions, that will reduce fracture risk in this population.
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Choi YJ, Shin DW, Jang W, Lee DH, Jeong SM, Park S, Han KD, Park YG. Risk of Dementia in Gastric Cancer Survivors Who Underwent Gastrectomy: A Nationwide Study in Korea. Ann Surg Oncol 2019; 26:4229-4237. [DOI: 10.1245/s10434-019-07913-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Indexed: 12/16/2022]
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Lee K, Kim KW, Lee JB, Shin Y, Jang JK, Yook JH, Kim BS, Lee IS. Impact of remnant stomach volume and anastomosis on nutrition and body composition in gastric cancer patients. Surg Oncol 2019; 31:75-82. [PMID: 31541910 DOI: 10.1016/j.suronc.2019.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/26/2019] [Accepted: 09/13/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND In gastrectomy for gastric cancer, oncologic safety including secure resection margin is considered important while less attention is given to maximizing remnant stomach volume (RSV). Nutrition and body composition are important postoperative factors for patient well-being. In this prospective observational study, we investigated the effects of RSV and anastomosing method on nutrition, anemia, and body composition change. METHODS We enrolled 247 patients who underwent curative laparoscopic gastrectomy (Billroth-1: 111, Billroth-2: 31, Roux-en-Y: 38, total gastrectomy: 67) for stage 1 gastric cancer between 2015 and 2016. Their clinicodemographic characteristics and laboratory data were collected. RSV, area of abdominal muscle, and subcutaneous/visceral fat were measured using CT data. RESULTS Patients with larger RSV and those who underwent Billroth-1 exhibited smaller reduction in hemoglobin and nutritional parameters during the first three postoperative months, and showed better recovery in the aforementioned variables as well in the first postoperative year. Visceral fat was the most affected factor by gastrectomy, and abdominal muscle and subcutaneous/visceral fat were better preserved in patients with larger RSV. The proportion of sarcopenic patients was also the smallest in the Billroth-1 group and larger RSV group. Patients who underwent total gastrectomy showed the highest degree of deterioration in all parameters. CONCLUSIONS Estimating RSV and body composition by using CT offers valuable clinical information. The Billroth-1 procedure and larger RSV were associated with better postoperative nutritional variables and reduced prevalence of sarcopenia among gastric cancer patients after gastrectomy. When performing gastrectomy in stage 1 gastric cancer patients, RSV should be considered.
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Affiliation(s)
- Koeun Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung-Bok Lee
- Division of Biostatistics, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yongbin Shin
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Kyoo Jang
- Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong-Hwan Yook
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Byung-Sik Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - In-Seob Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Choi MH, Kim KA, Hwang SS, Byun JY. CT-quantified muscle and fat change in patients after surgery or endoscopic resection for early gastric cancer and its impact on long-term outcomes. Medicine (Baltimore) 2018; 97:e13878. [PMID: 30593194 PMCID: PMC6314738 DOI: 10.1097/md.0000000000013878] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study was to evaluate the impact of the body composition changes on patients' long-term outcomes after endoscopic resection or surgery for mucosal gastric cancer.This case-control study included 96 patients who underwent endoscopic resection or surgery after propensity score matching. Areas of fat and muscle measured on CT were compared between the 2 groups. The effects of the variables on disease-free and overall survival were assessed using Cox-regression analysis and Kaplan-Meier survival analysis.The median overall survival of the surgical and endoscopic resection groups was 91.1 and 93.9 months (P = .080). Fat area was decreased significantly more after surgery (P < .001). The number of patients with sarcopenia was increased in the surgery group. Kaplan-Meier plot showed that overall survival was significantly correlated with post-treatment sarcopenia (P = .049).CT-based body composition analysis was helpful to evaluate the change in fat and muscle areas after treatment of early gastric cancer. The losses of fat and muscle after treatment were negatively associated with the patient overall survival.
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Affiliation(s)
- Moon Hyung Choi
- Department of Radiology, Seoul St. Mary's Hospital
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Shin DW, Suh B, Park Y, Lim H, Suh YS, Yun JM, Cho B, Yang HK. Risk of Coronary Heart Disease and Ischemic Stroke Incidence in Gastric Cancer Survivors: A Nationwide Study in Korea. Ann Surg Oncol 2018; 25:3248-3256. [PMID: 30043317 DOI: 10.1245/s10434-018-6635-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Small studies suggest improvement of cardiovascular risk profiles and reduced cardiovascular mortality after gastrectomy for gastric cancer. In our study using national health insurance data, we investigated coronary heart disease (CHD) and ischemic stroke incidence among gastric cancer patients who received gastrectomy compared with general population controls. METHODS A total of 98,936 gastric cancer patients were included in the study and matched to non-cancer controls via 1:1 propensity score matching. Competing risk regression analysis was used to determine the relative risk of CHD and ischemic stroke, with cancer mortality as the competing risk. Changes in cardiovascular risk profile before and after gastrectomy were tested, and factors associated with CHD or ischemic stroke incidence among gastric cancer patients were analyzed. RESULTS Compared with the matched controls, gastric cancer patients who received gastrectomy were shown to have a decreased risk for both CHD (subdistribution hazard ratio [SHR] 0.60, 95% confidence interval [CI] 0.57-0.63) and ischemic stroke (SHR 0.72, 95% CI 0.69-0.75). Decreases in body mass index (BMI), blood pressure, blood sugar, and lipid and hemoglobin levels were marked after gastrectomy. Among gastric cancer patients, those who lost > 5% of their body weight were at lower risk of developing CHD (SHR 0.82, 95% CI 0.71-0.96) and ischemic stroke (SHR 0.85, 95% CI 0.75-0.98). CONCLUSIONS CHD and ischemic stroke risk decreased after gastrectomy. The amount of weight loss and accompanying metabolic changes seemed to mediate the reduction of such risk. Reassessment of cardiovascular risk factors after gastrectomy and consideration of cardiovascular risk in the selection of treatment modality are suggested.
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Affiliation(s)
- Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Seoul, Republic of Korea
| | | | - Youngmin Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
| | - Hyunsun Lim
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Yun-Suhk Suh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - BeLong Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Han-Kwang Yang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Lee SJ, Kim JY, Ha TK, Choi YY. Changes in lipid indices and body composition one year after laparoscopic gastrectomy: a prospective study. Lipids Health Dis 2018; 17:113. [PMID: 29751766 PMCID: PMC5948801 DOI: 10.1186/s12944-018-0729-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this prospective study was to investigate changes in lipid indices associated with whole body composition during 1 year of follow-up after laparoscopic gastrectomy. Methods Thirty-seven patients with benign and malignant gastric neoplasm who underwent laparoscopic gastrectomy were prospectively enrolled. None of the patients were treated with adjuvant chemotherapy. Lipid indices and body composition were measured preoperatively and at six and 12 months after laparoscopic gastrectomy. Lipid indices included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Body weight, fat and lean body mass (LBM) were measured by dual-energy X-ray absorptiometry and the change in fat and LBM in the trunk, arms and legs was compared. Results Body weight significantly decreased from 63.0 ± 11.1 kg preoperatively to 56.8 ± 10.6 kg 12 months after laparoscopic gastrectomy, with a mean of 7.1% (4.6 kg) weight loss. Fat and LBM loss contributed 68.4% (3.1 kg) and 30.1% (1.4 kg) of the total weight loss, respectively. In both the non-obese and obese groups, body weight, fat and LBM did not change significantly between 6 months and 12 months after gastrectomy. TC and LDL-C levels significantly decreased during the first six-month period and HDL-C significantly increased until 12 months after gastrectomy in the non-obese group. In the obese group, the degree of reduction in fat mass was significantly higher and the LBM/weight ratio significantly increased compared with the non-obese group. However, there was no significant change in lipid indices in the obese group. The TG level was significantly correlated with fat, especially with trunk fat. Conclusion Gastrectomy resulted in improved lipid indices and a reduction in body weight, fat and LBM. The HDL-C significantly increased in the non-obese group for 1 year after gastrectomy and the reduction of TG level was positively correlated with fat, especially with trunk fat (IRB No. 2015-04-026. Registered 4 May 2015).
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Affiliation(s)
- Soo Jin Lee
- Department of Nuclear Medicine, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 133-792, South Korea
| | - Ji Young Kim
- Department of Nuclear Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 133-792, South Korea
| | - Tae Kyung Ha
- Department of Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 133-792, South Korea.
| | - Yun Young Choi
- Department of Nuclear Medicine, Hanyang University Medical Center, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 133-792, South Korea.
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Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014. J Gastric Cancer 2016; 16:131-140. [PMID: 27752390 PMCID: PMC5065942 DOI: 10.5230/jgc.2016.16.3.131] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 08/24/2016] [Accepted: 08/27/2016] [Indexed: 12/14/2022] Open
Abstract
Purpose The Korean Gastric Cancer Association (KGCA) has conducted nationwide surveys every 5 years, targeting patients who received surgical treatment for gastric cancer. We report the results of the 2014 nationwide survey and compare them to those of the 1995, 1999, 2004, and 2009 surveys. Materials and Methods From March 2015 to January 2016, a standardized case report form was sent to every member of the KGCA via e-mail. The survey consisted of 29 questions, regarding patient demographics as well as tumor-, and surgery-related factors. The completed data forms were analyzed by the KGCA information committee. Results Data on 15,613 patients were collected from 69 institutions. The mean age was 60.9±12.1 years, and the proportion of patients more than 70 years of age increased from 9.1% in 1995 to 25.3% in 2014. Proximal cancer incidence steadily increased from 11.2% in 1995 to 16.0% in 2014. Early gastric cancer incidence consistently increased and accounted for 61.0% of all cases in 2014. The surgical approach was diversified in 2014, and 7,818 cases (50.1%) were treated with a minimally invasive approach. The most common anastomosis was Billroth I (50.2%) after distal gastrectomy, and the proportion of Roux-en-Y anastomoses performed increased to 8.6%. Conclusions The results of this survey are expected to be important data for future studies and to be useful for generating a national cancer control program.
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Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy. Gastric Cancer 2015; 18:382-9. [PMID: 24715254 DOI: 10.1007/s10120-014-0365-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/28/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG. PATIENTS AND METHODS One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG. RESULTS At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20 ± 6.80 and 65.8 ± 36.1% of the preoperative values, respectively, and 26 patients (25.5%) showed a significant loss of skeletal muscle of more than 10%. Adjuvant chemotherapy with S-1 for ≥6 months (hazard ratio 26.61, 95% confidence interval, 3.487-203.1) was identified as the single independent risk factor for a significant loss of skeletal muscle. CONCLUSIONS Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes.
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Lee JW, Kim EY, Yoo HM, Park CH, Song KY. Changes of lipid profiles after radical gastrectomy in patients with gastric cancer. Lipids Health Dis 2015; 14:21. [PMID: 25889692 PMCID: PMC4374421 DOI: 10.1186/s12944-015-0018-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 03/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We investigated the changes of lipid profiles after radical gastrectomy. METHODS We analyzed the lipid-profile changes after radical gastrectomy in 144 patients with gastric cancer. Their lipid profiles, including total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL), and HDL-cholesterol (HDL), were evaluated preoperatively as well as 6 and 12 months postoperatively. We compared the changes of lipid profile according to the reconstruction type and resection extent. RESULTS The TC level had decreased 6 months after surgery, and remained unchanged thereafter. The LDL level also had decreased 6 months after surgery, but had increased again after 12 months after surgery. The HDL level had increased 12 months after surgery, whereas the TG level was unchanged. In a comparison of the lipid levels according to the reconstruction type or resection extent, the HDL level significantly differed by reconstruction type 12 months after surgery: it was markedly higher in the total gastrectomy than in the subtotal gastrectomy group both 6 months and 12 months after surgery. Both the male gender and total gastrectomy were associated with probability of normalization of LDL after surgery. CONCLUSIONS The lipid profiles including the TC, LDL and HDL levels were changed after radical gastrectomy; therefore, after this procedure, the lipid profiles of patients with hyperlipidemia should be evaluated.
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Affiliation(s)
- Jin Won Lee
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
| | - Eun Young Kim
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
| | - Han Mo Yoo
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
| | - Cho Hyun Park
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
| | - Kyo Young Song
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
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