Changes of weight and body composition after gastrectomy in the elderly gastric cancer patients.

Abstract

89 Background: Body weight, especially lean body mass, significantly reduces after gastrectomy for gastric cancer due to surgical invasion, reduced food intake, or decreased mobility, which could decrease quality of life and toxicity / compliance of adjuvant chemotherapy. These risks might be high especially in the elderly gastric cancer patients. However, it remains unclear whether changes of weight and body composition are different between the elderly and the non-elderly. Methods: This retrospective study examined patients who underwent curative surgery for gastric cancer between June 2010 and March 2014. Body weight and composition were evaluated by a bioelectrical impedance analyzer within 1 week before surgery (first measurement), at 1 week after surgery (second measurement), at 1 month after surgery (third measurement), and at 3 months after surgery (forth measurement). Patients were classified to the elderly (> 75 years) and the non-elderly ( < 75 years). Results: Four-hundred forty three patients (100 for the elderly and 343 for the non-elderly) were entered in the present study. Patients backgrounds, surgical factors, clinicopathological factors, surgical complications and adjuvant chemotherapy were not significantly different between the two groups. %Body weight loss until 1week, 1month, 3 months after surgery, defined as the proportion of the difference between 1st measurement and each measurement after surgery against 1st measurement, was 3.3%, 6.6%, and 9.7%, respectively in the elderly and 3.7%, 5.4%, and 8.2%, respectively in the non-elderly with significant difference (p = 0.05, 0.01, and 0.01, respectively). %Lean body mass loss until 1 week, 1 month, 3 months after surgery was 3.2%, 5.6%, and 6.1%, respectively in the elderly and 3.2%, 4.5%, and 4.2%, respectively in the non-elderly with p value of 0.36, 0.08, and 0.01, respectively. %Fat loss was not significantly different between the two groups at any time. Conclusions: Decreases in body weight and lean body mass after gastrectomy were more serious in the elderly patients as compared with the non-elderly. Surgical indication for the elderly must be carefully determined considering the risk and the benefit.