Ann Clin Nutr Metab.  2021 Dec;13(2):52-61. 10.15747/ACNM.2021.13.2.52.

Long-Term Changes of Body Mass Index and Nutritional Biochemical Markers in the Obese Elderly with Gastric Cancer

• KMID: 2524535
• DOI: http://doi.org/10.15747/ACNM.2021.13.2.52

Abstract

Purpose
This study investigated change of body mass index (BMI) and nutritional biochemical markers after gastrectomy according to the preoperative obesity in the elderly gastric cancer patients, and evaluated their short- and long-term clinical outcomes.
Materials and Methods
Gastric cancer patients (age≥65 years, BMI≥25 kg/m² ) who underwent curative gastrectomy from 2014 to 2015 were enrolled in this study. BMI, comorbidity, extent of surgical resection, surgical approaches, postoperative complications, cancer stage, adjuvant chemotherapy, and survival data were collected. Nutritional parameters were collected until 4 years after surgery. The patients were classified into two groups according to preoperative BMI: Obesity group (25 kg/m 2 ≤BMI<30 kg/m² ) and severe-obesity group (BMI≥30 kg/m² ).
Results
Of the total 266 patients, 210 patients were categorized as the obesity group and 16 as the severe-obesity group. Postoperative complications were comparable between the two groups. The BMI decreased by more than 10% at 12 months after gastrectomy, and remained at a similar level during the 4 year-follow-up period in both groups. At 4 years after surgery, the nutritional biomarkers were nearly comparable to preoperative levels in each group. The severeobesity group were associated with poor overall survival rate (P=0.011).
Conclusion
BMI decreased by more than 10% after gastrectomy in obese elderly, but nutritional biomarker levels were comparable before and after gastrectomy. The overall survival rate was lower in severely obese elderly than in obese elderly. Therefore, it is considered that severely obese elderly gastric cancer patients should be monitored, and vigorous efforts are needed to reduce high-BMI.

Keyword

Stomach neoplasms; Obesity; Aged