Ann Surg Treat Res.  2019 May;96(5):250-258. 10.4174/astr.2019.96.5.250.

Impact of body mass index on quality of life after distal gastrectomy for gastric cancer

• Park KB
• Yu B
• Park JY
• Kwon OK
• Yu W

• KMID: 2443588
• DOI: http://doi.org/10.4174/astr.2019.96.5.250

Abstract

PURPOSE
Few studies have evaluated changes in quality of life (QoL) in relation to changes in body mass index (BMI) after gastrectomy. This study aimed to evaluate the impact of postoperative changes in BMI on QoL after distal gastrectomy in gastric cancer patients.
METHODS
QoL data from the European Organization for the Research and Treatment of Cancer (EORTC) gathered via the QLQ-C30 and QLQ-STO22 questionnaires were obtained from 1,036 patients preoperatively and at 1 year postoperatively. The patients were divided into 2 groups: group 1 - decreased postoperative BMI and group 2 - unchanged or increased postoperative BMI.
RESULTS
There were 577 patients in group 1 and 459 in group 2. According to global health status and functional scales, emotional functioning (P = 0.035) was significantly worse in group 1 than in group 2 at 1 year postoperatively. Furthermore, there were significant decreases in QoL symptom scale scores, including fatigue (P = 0.016), nausea and vomiting (P = 0.002), and appetite loss (P = 0.001) scores, in group 1 compared with group 2. Regarding QLQ-STO22, reflux symptoms (P = 0.020), anxiety (P = 0.003), and body image (P = 0.003) were significantly worse in group 1 than in group 2 at 1 year after surgery.
CONCLUSION
BMI changes after distal gastrectomy influence QoL. Focus on controlling gastrointestinal symptoms and providing psychological support is essential in patients with decreased BMI after surgery. Patients should be offered follow-up care to assist them in maintaining BMI, for example, through dietary-behavior modifications and via intensive nutritional support, to prevent QoL deterioration after distal gastrectomy.

Keyword

Quality of life; Body mass index; Gastrectomy; Stomach neoplasm

MeSH Terms

Anxiety
Appetite
Body Image
Body Mass Index*
Fatigue
Follow-Up Studies
Gastrectomy*
Global Health
Humans
Nausea
Nutritional Support
Quality of Life*
Stomach Neoplasms*
Vomiting
Weights and Measures

Figure

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  Fig. 1 Body mass index shift after distal gastrectomy. Underweight (<18.50 kg/m2), normal (18.50–22.99 kg/m2), overweight (23.00–24.99 kg/m2), and obese (≥25.00 kg/m2).

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  Fig. 2 Mean score of quality of life preoperatively and postoperatively 1 year after distal gastrectomy. GH, global health status; PF2, physical functioning; RF2, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning; FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhea; FI, financial difficulties; XDG, dysphagia; Xpain, pain; XRflx, reflux symptoms; XEatR, eating restrictions; Anx, anxiety; DM, having a dry mouth; T, taste; BI, body image; HL, hair loss. *P < 0.05.

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  Fig. 3 Changes in quality of life according to body mass index shifts 1 year after distal gastrectomy between groups 1 and 2. GH, global health status; PF2, physical functioning; RF2, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning; FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhea; FI, financial difficulties; XDG, dysphagia; Xpain, pain; XRflx, reflux symptoms; XEatR, eating restrictions; Anx, anxiety; DM, having a dry mouth; T, taste; BI, body image; HL, hair loss. *P < 0.05.

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  Fig. 4 Changes in quality of life between subgroups 1 and 2. GH, global health status; PF2, physical functioning; RF2, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning; FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhea; FI, financial difficulties; XDG, dysphagia; Xpain, pain; XRflx, reflux symptoms; XEatR, eating restrictions; Anx, anxiety; DM, having a dry mouth; T, taste; BI, body image; HL, hair loss.

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  Fig. 5 Changes in quality of life between subgroups 2 and 3. GH, global health status; PF2, physical functioning; RF2, role functioning; EF, emotional functioning; CF, cognitive functioning; SF, social functioning; FA, fatigue; NV, nausea and vomiting; PA, pain; DY, dyspnea; SL, insomnia; AP, appetite loss; CO, constipation; DI, diarrhea; FI, financial difficulties; XDG, dysphagia; Xpain, pain; XRflx, reflux symptoms; XEatR, eating restrictions; Anx, anxiety; DM, having a dry mouth; T, taste; BI, body image; HL, hair loss. *P < 0.05.

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