Risk Factors for Body Weight Loss After Gastrectomy for Gastric Cancer Analyzed From the JCOG1001 Phase III Trial

Area of Science:

• Oncology
• Surgical Gastroenterology
• Clinical Nutrition

Background:

• Gastric cancer surgery, including gastrectomy, often leads to significant body weight loss (BWL).
• Understanding factors associated with BWL is crucial for managing patient outcomes post-gastrectomy.
• The JCOG1001 trial provides a robust dataset for investigating these associations.

Purpose of the Study:

• To identify and analyze factors associated with substantial body weight loss (BWL) after gastrectomy.
• To determine the independent risk factors for achieving a %BWL of 10% or greater in patients undergoing gastrectomy.

Main Methods:

• A post hoc analysis of 728 patients from the JCOG1001 phase III trial was conducted.
• %BWL was defined as body weight decrease from pre-surgery to pre-adjuvant chemotherapy initiation.
• Logistic regression analysis was used to identify independent risk factors for %BWL ≥ 10%.

Main Results:

• 35.4% of patients experienced %BWL ≥ 10%.
• Factors associated with higher %BWL included male sex, preoperative BMI ≥ 25, total gastrectomy, longer operation time, and greater blood loss.
• Multivariable analysis identified preoperative BMI ≥ 25, total gastrectomy, and grade 2-4 postoperative complications as independent risk factors.

Conclusions:

• High preoperative BMI, undergoing total gastrectomy, and experiencing postoperative complications are significant risk factors for substantial BWL post-gastrectomy.
• These findings aid in identifying at-risk patients and developing targeted interventions to mitigate BWL after gastric cancer surgery.