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Body Compositions of Elderly and Non-Elderly Patients Following Gastrectomy for Gastric Cancer
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Ji Hoon Kang, Mi Ran Jung, Sung Eun Kim, Oh Jeong
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Ann Clin Nutr Metab 2022;14(2):81-87. Published online December 1, 2022
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DOI: https://doi.org/10.15747/ACNM.2022.14.2.81
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 Abstract
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- Purpose: Radical gastric resection is the mainstay of treatment in gastric cancer. However, patients can suffer from eating restrictions, weight loss, and malnutrition after gastrectomy, to which elderly patients are more vulnerable. We compared body composition changes in elderly patients and non-elderly patients after gastrectomy.
Materials and Methods: This prospective study enrolled patients who underwent gastrectomy for gastric carcinoma between 2019 and 2021. Body composition was measured using bioelectrical impedance analysis (InBody S10) before surgery and up to 12 months after surgery. Patients were divided into an elderly group (>70 years) and a non-elderly group (≤70 years), and body composition changes were compared between the two groups using the linear mixed model.
Results: There were 69 patients in the elderly group and 164 patients in the non-elderly group. The groups showed no significant differences in gastric resection or pathologic stage. Overall, body composition, including total body water, body weight, lean body mass, skeletal muscle mass, and fat mass, decreased immediately after surgery and gradually improved until postoperative 12 months. A linear mixed model showed no significant time×group interactions for any body composition factors between groups.
Conclusion: Body composition changes did not significantly differ between elderly patients and non-elderly patients after gastrectomy.
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Longitudinal Change in Health-Related Quality of Life after Total Gastrectomy: Approach Based on the Minimally Important Difference
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Sang Chun Park, Oh Jeong, Ji Hoon Kang, Mi Ran Jung
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Ann Clin Nutr Metab 2021;13(2):43-51. Published online December 31, 2021
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DOI: https://doi.org/10.15747/ACNM.2021.13.2.43
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Abstract
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- Purpose: The post-operative quality of life (QoL) is a significant concern for patients undergoing gastrectomy. Unlike subtotal gastrectomy, the detailed aspects of QoL involving the ability to perform everyday activities that reflect physical, psychological, and social well-being; and satisfaction with levels of functioning and control of the disease after total gastrectomy remain poorly investigated.
Materials and Methods: We enrolled 170 patients who underwent total gastrectomy for gastric carcinoma and completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaires (QLQ) C30 and STO22 preoperatively and post-operatively at 1, 6, and 12 months. We investigated the QoL change in terms of the minimally important difference (MID), which refers to a score change patients would perceive as clinically important (effect size >0.5).
Results: At 1-month post-surgery, MID in global health, physical, social, role, emotional, and cognitive functions was observed at 44.0%, 68.0%, 42.7%, 38.7%, 32.0%, and 16.0% respectively. Of QLQ-C30 symptoms, MID was frequently observed in appetite (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (74.1%), dysphagia (63.5%), pain (51.8%), and anxiety (50.6%). At 12 months post-surgery, MID in global health, physical, role, cognitive, social, and emotional functions was 32.9%, 58.8%, 42.4%, 40.0%, 36.5%, and 17.6%, respectively. Of QLQ-C30 symptoms, MID was frequently observed in diarrhea (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (63.5%), dysphagia (52.9%), body image (55.3%), pain (55.3%), and anxiety (51.8%). Male sex, comorbidity, D2 lymphadenectomy, and post-operative morbidity were associated with MID in global health at 12 months post-surgery.
Conclusion: This study provides information about the detailed aspects of impairment in various functions and symptoms of QoL after total gastrectomy. This information can be used to develop a tailor-made management plan for QoL.
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