Title : Analysis of postoperative body weight change and its influencing factors for gastric cancer
Abstract:
Background: The high incidence and mortality of gastric cancer (GC) pose a significant threat to human life and health and have become an important public health problem in China. Body weight loss is a common problem in GC patients after surgical treatment. It is associated with a poor prognosis and even GC recurrence. However, the current attention to postoperative weight change for GC is still insufficient, and the descriptions of postoperative weight change and its influencing factors are also different. Hence, this study was to exploere the overall trend in body weight changes after gastrectomy and identify factors influencing these changes. By doing so, to provide reference for guiding clinical weight management and formulating nutrition management program.
Aims: To describe the body weight change in GC patients 6 months after gastrectomy and to identify the factors influencing these dynamic changes.
Methods: A total of 121 GC patients admitted to the First Afliated Hospital, Zhejiang University School of Medicine from October 2021 to September 2022 were selected as research objects by convenient sampling method. We collected data before (T0) and 1 (T1), 3 (T2), and 6 (T3) months after gastrectomy using a general data questionnaire, a psychological distress thermometer, and body weight. The general estimation equation was used to analyze the dynamic trend and influencing factors of body weight in GC patients within 6 months after 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 weight of GC patients decreased 6 months following gastrectomy, and the time had a significant effect (χ2 = 331.407, P < 0.001). Generalized estimation equation results showed that preoperative body mass index (BMI), significant psychological distress, religious belief, and gender were risk factors for weight loss in patients with GC 0–6 months 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). Patients with significant psychological distress were more likely to lose weight than those without significant psychological distress (β = 2.490, P < 0.001), and religious patients were less likely to lose weight 6 months 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 months after gastrectomy (β = 4.262, P = 0.038).
Conclusion: This study suggests that the weight of GC patients decreased 6 months after gastrectomy. Male patients with high preoperative BMI levels, significant psychological distress, and no religious belief were more likely to lose weight after gastrectomy. Clinicians should pay attention to the long-term follow-up of the postoperative weight of GC patients, monitor changes in BMI, and dynamically pay attention to the weight and psychological changes of patients.
