Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2024; 16(7): 2242-2254
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2242
Postoperative body weight change and its influencing factors in patients with gastric cancer
Yan Li, Li-Hua Huang, Hui-Di Zhu, Ping He, Bei-Bei Li, Li-Jing Wen
Yan Li, Hui-Di Zhu, Ping He, Bei-Bei Li, Li-Jing Wen, Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Li-Hua Huang, Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Li Y designed and conducted the study and wrote the manuscript; Huang LH designed the study and reviewed the manuscript; Zhu HD provided clinical advice; He P, Li BB, and Wen LJ collected the data; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital, Zhejiang University School of Medicine Institutional Review Board (approval No. IIT20210221B).
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset is available from the corresponding author at lihuahuang818@zju.edu.cn.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Hua Huang, MBBS, Chief Nurse, Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. lihuahuang818@zju.edu.cn
Received: February 29, 2024
Revised: May 16, 2024
Accepted: June 3, 2024
Published online: July 27, 2024
Processing time: 143 Days and 21.8 Hours
Abstract
BACKGROUND

The high incidence and mortality of gastric cancer (GC) pose a significant threat to human life and health, and it has become an important public health challenge in China. Body weight loss is a common complication after surgical treatment in patients with GC and is associated with poor prognosis and GC recurrence. However, current attention to postoperative weight change in GC patients remains insufficient, and the descriptions of postoperative weight change and its influencing factors are also different.

AIM

To investigate body weight changes in patients with GC within 6 mo after gastrectomy and identify factors that influence dynamic body weight changes.

METHODS

We conducted a prospective longitudinal study of 121 patients with GC and collected data before (T0) and 1 (T1), 3 (T2), and 6 (T3) mo after gastrectomy using a general data questionnaire, psychological distress thermometer, and body weight measurements. The general estimation equation (GEE) was used to analyze the dynamic trends of body weight changes and factors that influence body weight changes in patients with GC within 6 mo of gastrectomy.

RESULTS

The median weight loss at T1, T2, and T3 was 7.29% (2.84%, 9.40%), 11.11% (7.64%, 14.91%), and 14.75% (8.80%, 19.84%), respectively. The GEE results showed that preoperative body mass index (BMI), significant psychological distress, religious beliefs, and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy (P < 0.05). Compared with preoperative low-weight patients, preoperative obese patients were more likely to have weight loss (β = 14.685, P < 0.001). Furthermore, patients with significant psychological distress were more likely to lose weight than those without (β = 2.490, P < 0.001), and religious patients were less likely to lose weight 6 mo after gastrectomy than those without religious beliefs (β = -6.844, P = 0.001). Compared to female patients, male patients were more likely to experience weight loss 6 mo after gastrectomy (β = 4.262, P = 0.038).

CONCLUSION

Male patients with GC with high preoperative BMI, significant psychological distress, and no religious beliefs are more likely to lose weight after gastrectomy.

Keywords: Gastric cancer; Gastrectomy; Weight loss; Influencing factors; Body mass index

Core Tip: Body weight loss after surgical treatment is common in patients with gastric cancer (GC) and is associated with a poor prognosis and GC recurrence. We observed the changes of body weight in 121 patients with GC within 6 mo after surgery and analyzed the influencing factors. Our study found that preoperative body mass index, significant psychological distress, religious beliefs, and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy.