Cancer Research and Treatment

Original Articles

Impact of Body Mass Index on the Quality of Life after Total Gastrectomy for Gastric Cancer: Ki Bum Park, Ji Yeon Park, Seung Soo Lee, Oh Kyoung Kwon, Ho Young Chung, Wansik Yu; Cancer Res Treat. 2018;50(3):852-860. Published online September 13, 2017; DOI: https://doi.org/10.4143/crt.2017.080

Purpose
We evaluated the impact of postoperative body mass index (BMI) shifts on the quality of life (QoL) following total gastrectomy in patients with gastric cancer.
Materials and Methods
QoL data collected from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and QLQ-STO22 questionnaires were obtained from 417 patients preoperatively and 1 year after surgery. Patients were divided into two groups based on changes in BMI: group 1 comprised patientswhose BMIrange category dropped, and group 2 included patients who maintained or rose to a higher category compared to their preoperative BMI category.
Results
There were 276 patients in group 1 and 141 in group 2. QoLs with respect to the global health status and functional scales were not significantly different between the groups 1 year after surgery. However, there were significantly greater decreases in QoL in group 1 due to gastrointestinal symptoms, such as nausea and vomiting (p=0.008), appetite loss (p=0.001), and constipation (p=0.038). Of the QLQ-STO22 parameters, dysphagia (p=0.013), pain (p=0.012), reflux symptoms (p=0.017), eating restrictions (p=0.007), taste (p=0.009), and body image (p=0.009) were associated with significantly worse QoL in group 1 than in group 2 1 year after surgery.
Conclusion
Patients have significantly different QoLs depending on the BMI shift after total gastrectomy. Efforts to reduce the gap in QoL should include intensive nutritional support and restoration of dietary behaviors. Appropriate clinical and institutional approaches, plus active medical interventions, are required for maintaining patients’ BMIs after surgery.

Citations

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Nutritional Experiences of Patients Undergoing Total Gastrectomy Surgery
Derya Şayır, Kevser Karacabay
Gastroenterology Nursing.2024; 47(3): 203. CrossRef
Exploring the Association between Health-Related Physical Fitness and Quality of Life in Patients with Cancer: A Cross-Sectional Study
Anita Borsati, Diana Giannarelli, Lorenzo Belluomini, Christian Ciurnelli, Alessio Colonna, Irene D’Amico, Arianna Daniele, Nicole Del Bianco, Linda Toniolo, Ilaria Trestini, Daniela Tregnago, Jessica Insolda, Marco Sposito, Massimo Lanza, Michele Milella
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Research Progress on the Relationship between Nutritional Support and Postoperative Quality of Life in Patients with Gastric Cancer
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U-shaped association between body mass index and health-related quality of life impairment in Korean cancer survivors: a nationwide representative cross-sectional survey
Jong Eun Park, Kyoung Eun Yeob, So Young Kim, Chul-Woung Kim, Hye Sook Han, Jong Hyock Park
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The Predictive Value of a New Inflammatory-Nutritional Score for Quality of Life after Laparoscopic Distal Gastrectomy for Gastric Cancer
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Advantages of Distal Subtotal Gastrectomy over Total Gastrectomy in the Quality of Life of Long-Term Gastric Cancer Survivors
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Chronological changes in quality of life and body composition after gastrectomy for locally advanced gastric cancer
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Health-related quality of life in curatively-treated patients with esophageal or gastric cancer: A systematic review and meta-analysis
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Impact of body mass index on quality of life after distal gastrectomy for gastric cancer
Ki Bum Park, Byunghyuk Yu, Ji Yeon Park, Oh Kyoung Kwon, Wansik Yu
Annals of Surgical Treatment and Research.2019; 96(5): 250. CrossRef

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Chronological Changes of Quality of Life in Long-Term Survivors after Gastrectomy for Gastric Cancer: Wansik Yu, Ki Bum Park, Ho Young Chung, Oh Kyoung Kwon, Seung Soo Lee; Cancer Res Treat. 2016;48(3):1030-1036. Published online January 6, 2016; DOI: https://doi.org/10.4143/crt.2015.398

Abstract PDF PubReader ePub

Purpose
A few studies have prospectively evaluated changes in quality of life (QoL) after surgery in short-term survivors; however, no prospective study has evaluated the longitudinal changes in QoL in long-terms survivors. We prospectively evaluated the chronological changes in QoL after a gastrectomy over a 5-year postoperative period in a large group of patients. Materials and Methods QoL data from the European Organization for Research and Treatment of Cancer QLQ-C30 and the QLQ-STO22 questionnaires were obtained from 254 patients who completed the entire series of QoL assessments preoperatively and at 1, 2, 3, 4, and 5 years after surgery.
Results
There was no statistically significant change in global health status/QoL during the 5-year postoperative period. Decreases in QoL from upper gastrointestinal symptoms including diarrhea (p < 0.001), dysphagia (p < 0.001), reflux symptoms (p=0.029), and eating restrictions (p < 0.001) were observed among the long-term survivors. Decreased physical functioning (p < 0.001), role functioning (p < 0.001), and cognitive functioning (p < 0.001), along with fatigue (p=0.045) and a poor body image (p=0.003), negatively impacted the patients’ QoL for a long time. Conclusion Management of gastrointestinal symptoms should be specifically targeted as a part of longterm patient care after a gastrectomy. Proper nutritional care will improve food intake resulting in weight gain and improved physical functioning, role functioning, and body image. In addition, patients should be encouraged to preserve self-esteem and maintain social activity.

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20,198 View
209 Download
62 Web of Science
59 Crossref

Early Postoperative Intraperitoneal Chemotherapy for Macroscopically Serosa-Invading Gastric Cancer Patients: Oh Kyoung Kwon, Ho Young Chung, Wansik Yu; Cancer Res Treat. 2014;46(3):270-279. Published online July 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.3.270

Abstract PDF PubReader ePub

Purpose
Peritoneal recurrence is one of the most common patterns of recurrence after gastric cancer surgery and it has a poor prognosis despite all efforts. The aim of this study is to evaluate the prognostic impact of early postoperative intraperitoneal chemotherapy (EPIC) after surgery with curative intent for macroscopically serosa-invading gastric cancer patients. Materials and Methods The records of 245 patients under the age of 70 were reviewed. These patients were suffering from macroscopically seroa-invading gastric cancer and they underwent curative surgery from 1995 to 2004 at the Kyungpook National University Hospital, Daegu, Korea. The overall survival, gastric cancer-specific survival, complications, and patterns of recurrence were compared between the patients who were treated with EPIC and those who were not. Results EPIC was administered to 65 patients, and the remaining 180 patients did not receive this treatment. The 5-year overall and gastric cancer-specific survival rates for the EPIC group were 47.4% and 53.1%, respectively, and those for the non-EPIC group were 26.7% and 29.7%, respectively (p=0.012 for overall survival and p=0.011 for gastric cancer-specific survival). The rates of peritoneal recurrence for the EPIC group and the non-EPIC group were 18.5% and 32.2%, respectively (p=0.038). There were no significant differences in the morbidity or mortality between the two groups. Based on a multivariate analysis of the factors with prognostic significance in univariate analyses, EPIC, pathological lymph node metastasis, differentiation, and the extent of gastric resection were independent prognostic factors. Conclusion The use of EPIC to treat gastric cancer patients with macroscopic serosal invasions resulted in better survival rate by reducing the risk of peritoneal recurrence.

Citations

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Quality of Life of Long-Term Survivors after a Distal Subtotal Gastrectomy: Seung Soo Lee, Ho Young Chung, Wansik Yu; Cancer Res Treat. 2010;42(3):130-134. Published online September 30, 2010; DOI: https://doi.org/10.4143/crt.2010.42.3.130

Abstract PDF PubReader ePub

Purpose

The aim of this study was to investigate the impact of a distal subtotal gastrectomy on the quality of life (QoL).

Materials and Methods

The QoL data of 126 patients were obtained on their 5th annual follow-up visit after a curative distal subtotal gastrectomy for gastric cancer (Group A). The QoL data of 130 age- and gender-adjusted healthy population were obtained from the individuals who visited the health screening center for a medical check-up (Group B). There were 42 women and 84 men in the study group and their mean age was 56.0±11.1 years. QoL was assessed using the Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and QLQ-STO22.

Results

The EORTC QLQ-C30 global health status and QoL scores of Group A and Group B were 63.9±22.7 and 61.3±22.1, respectively (p=0.361). Group A revealed a better score for emotional functioning (84.1±16.1 and 75.2±21.4, respectively; p<0.001), cognitive functioning (82.0±16.4 and 75.0±21.4, respectively; p=0.004) and fatigue (27.7±20.8 and 33.8±23.2, respectively; p=0.028). However, Group A revealed a worse score for nausea and vomiting (14.8±20.0 and 10.2±16.0, respectively; p=0.042), financial difficulties (14.8±22.9 and 7.1±16.1, respectively; p=0.002), reflux (16.7±17.7 and 10.1±17.0, respectively; p=0.003), eating restrictions (13.6±15.2 and 6.6±10.2, respectively; p<0.001) and body image (23.3±25.4 and 16.2±24.6, respectively; p=0.023).

Conclusion

The QoL of long-term survivors after a distal subtotal gastrectomy is still influenced by the surgery itself even though they are considered to be free of disease.

Citations

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The impact of the 30-day postoperative complications on the quality of life following gastrectomy for gastric carcinoma: A prospective study
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Scientific Reports.2023;[Epub] CrossRef
Long-term health-related quality of life in patients with gastric cancer after total or distal gastrectomy: A propensity score-matched cohort study
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Ki Bum Park, Seung Soo Lee, Oh Kyoung Kwon, Ho Young Chung, Wansik Yu
Journal of Gastric Cancer.2017; 17(2): 110. CrossRef
Total Gastrectomy for Hereditary Diffuse Gastric Cancer at a Single Center
Vivian E. Strong, Sepideh Gholami, Manish A. Shah, Laura H. Tang, Yelena Y. Janjigian, Mark Schattner, Luke V. Selby, Sam S. Yoon, Erin Salo-Mullen, Zsofia K. Stadler, David Kelsen, Murray F. Brennan, Daniel G. Coit
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Vicky Lehmann, Mariët Hagedoorn, Marrit A. Tuinman
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Gianmauro Numico, Vito Longo, Giulia Courthod, Nicola Silvestris
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Edgaras Smolskas, Raimundas Lunevicius, Narimantas Evaldas Samalavicius
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Development and Evaluation of Korean Version of Quality of Sexual Function (QSF-K) in Healthy Korean Women
Yumi Lee, Myong Cheol Lim, Yedong Son, Jungnam Joo, KiByung Park, Jung-Sup Kim, Dong Ock Lee, Sang-Yoon Park
Journal of Korean Medical Science.2014; 29(6): 758. CrossRef
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No Association of Vascular Endothelial Growth Factor-A (VEGF-A) and VEGF-C Expression with Survival in Patients with Gastric Cancer: Soo Jung Lee, Jong Gwang Kim, Sang Kyun Sohn, Yee Soo Chae, Joon Ho Moon, Shi Nae Kim, Han-Ik Bae, Ho Young Chung, Wansik Yu; Cancer Res Treat. 2009;41(4):218-223. Published online December 31, 2009; DOI: https://doi.org/10.4143/crt.2009.41.4.218

Abstract PDF PubReader ePub

Purpose

Although the vascular endothelial growth factor (VEGF) superfamily has been identified to critically influence tumor-related angiogenesis, the prognostic significance of a VEGF expression in gastric cancer is still controversial. Accordingly, the present study analyzed the VEGF-A and VEGF-C expressions and their impact on the prognosis of patients with gastric cancer.

Materials and Methods

Three hundred seventy-five consecutive patients who underwent surgical resection for gastric adenocarcinoma with a curative intent were enrolled in the present study. Immunohistochemical staining for VEGF-A and VEGF-C was performed using the formalin fixed, paraffin embedded tumor tissues.

Results

Positive VEGF-A and VEGF-C expressions were observed in 337 (90.1%) and 278 (74.9%) cases, respectively. The survival analysis showed that the expression of VEGF-A and VEGF-C had no effect on the OS and DFS. On the multivariate analysis that included age, gender and the TNM stage, no significant association between the grade of the VEGF-A or VEGF-C expression and survival was observed.

Conclusion

The current study suggests that the tissue expression of VEGF-A or VEGF-C alone is not an independent prognostic marker for patients with surgically resected gastric adenocarcinoma.

Citations

Citations to this article as recorded by

VEGF-C and Lymphatic Vessel Density in Tumor Tissue of Gastric Cancer: Correlations with Pathoclinical Features and Prognosis
Mariusz Szajewski, Maciej Ciesielski, Rafał Pęksa, Piotr Kurek, Michał Stańczak, Jakub Walczak, Jacek Zieliński, Wiesław Janusz Kruszewski
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Lara Alessandrini, Melissa Manchi, Valli De Re, Riccardo Dolcetti, Vincenzo Canzonieri
International Journal of Molecular Sciences.2018; 19(6): 1683. CrossRef
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Charles S Fuchs, Josep Tabernero, Jiří Tomášek, Ian Chau, Bohuslav Melichar, Howard Safran, Mustapha A Tehfe, Dumitru Filip, Eldar Topuzov, Luis Schlittler, Anghel Adrian Udrea, William Campbell, Stephen Brincat, Michael Emig, Symantha A Melemed, Rebecca
British Journal of Cancer.2016; 115(8): 974. CrossRef
Fentanyl inhibits the progression of human gastric carcinoma MGC-803 cells by modulating NF-κB-dependent gene expression in vivo
GUODONG HE, LI LI, ENJIAN GUAN, JING CHEN, YI QIN, YUBO XIE
Oncology Letters.2016; 12(1): 563. CrossRef
Disrupted Balance of MMPs/TIMPs in Gastric Carcinogenesis–Paradoxical Low MMP-2 Expression in Tumor and Stromal Compartments as a Potential Marker of Unfavorable Outcome
Piotr Donizy, Julia Rudno-Rudzinska, Maciej Kaczorowski, Jedrzej Kabarowski, Ewelina Frejlich, Wojciech Kielan, Rafal Matkowski, Agnieszka Halon
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Kyung Ho Pak, Ara Jo, Hye Ji Choi, Younghee Choi, Hyunki Kim, Jae-Ho Cheong
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Ismael Riquelme, Kathleen Saavedra, Jaime A. Espinoza, Helga Weber, Patricia García, Bruno Nervi, Marcelo Garrido, Alejandro H. Corvalán, Juan Carlos Roa, Carolina Bizama
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VEGF-C expression is associated with the poor survival in gastric cancer tissue
Weiguo Cao, Rong Fan, Weiping Yang, Yunlin Wu
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VEGF-A clinical significance in gastric cancers: Immunohistochemical analysis of a wide Italian cohort
E. Lastraioli, L. Boni, M.R. Romoli, S. Crescioli, A. Taddei, S. Beghelli, A. Tomezzoli, C. Vindigni, L. Saragoni, L. Messerini, M. Bernini, L. Bencini, E. Giommoni, G. Freschi, F. Di Costanzo, A. Scarpa, P. Morgagni, M. Farsi, F. Roviello, G. De Manzoni,
European Journal of Surgical Oncology (EJSO).2014; 40(10): 1291. CrossRef
Prognostic value of vascular endothelial growth factor A expression in gastric cancer: a meta-analysis
Ya-nan Ji, Qin Wang, Yang Li, Zhi Wang
Tumor Biology.2014; 35(3): 2787. CrossRef
Clinicopathologic Significance of Nuclear Factor-κB and Vascular Endothelial Growth Factor Expression in Advanced Gastric Cancer Patients
Keon Woo Park, Su-Jin Kim, Sung Yong Oh
Oncology Research and Treatment.2014; 37(4): 183. CrossRef
Prognostic Value of Vascular Endothelial Growth Factor Expression in Resected Gastric Cancer
Lei Liu, Xue-Lei Ma, Zhi-Lan Xiao, Mei Li, Si-Hang Cheng, Yu-Quan Wei
Asian Pacific Journal of Cancer Prevention.2012; 13(7): 3089. CrossRef
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Marco Lionello, Alberto Staffieri, Gino Marioni
Acta Oto-Laryngologica.2012; 132(6): 574. CrossRef
Prognostic significance of vascular endothelial growth factor immunohistochemical expression in gastric cancer: a meta-analysis
Ling Peng, Ping Zhan, Yun Zhou, Weijia Fang, Peng Zhao, Yulong Zheng, Nong Xu
Molecular Biology Reports.2012; 39(10): 9473. CrossRef
Protein Kinase B Phosphorylation Correlates with Vascular Endothelial Growth Factor A and Microvessel Density in Gastric Adenocarcinoma
Xd Zhou, Hx Chen, Rn Guan, Yp Lei, X Shu, Y Zhu, Nh Lv
Journal of International Medical Research.2012; 40(6): 2124. CrossRef
Prognostic significance of vascular endothelial growth factor expression in gastric carcinoma: a meta-analysis
Jing Chen, Tao Li, Yuanyuan Wu, Lijun He, Li Zhang, Tieliu Shi, Zhengfang Yi, Mingyao Liu, Xiufeng Pang
Journal of Cancer Research and Clinical Oncology.2011; 137(12): 1799. CrossRef
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U. Silván, A. Díez‐Torre, L. Jiménez‐Rojo, J. Aréchaga
International Journal of Andrology.2010; 33(6): 765. CrossRef
Cancer-associated fibroblasts are positively correlated with metastatic potential of human gastric cancers
Kangkang Zhi, Xiaojun Shen, Hao Zhang, Jianwei Bi
Journal of Experimental & Clinical Cancer Research.2010;[Epub] CrossRef

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Phase I and Pharmacokinetic Study of Intraoperative Intraperitoneal Heptaplatin in Patients with Surgically Resected Advanced Gastric Cancer: Wansik Yu, Ho Young Chung, So Hyang Park, Yong Baik Cho, Yang Soo Lim; Cancer Res Treat. 2003;35(1):25-29. Published online February 28, 2003; DOI: https://doi.org/10.4143/crt.2003.35.1.25

Abstract PDF: PURPOSE
Heptaplatin, a new platinum analog, has favorable toxicity profiles and antitumor activity, comparable to those of cisplatin, in the treatment of gastric cancer. This study was designed to define the maximum tolerated dose (MTD), dose-limiting toxicity (DLT) and pharmacokinetics of heptaplatin administered by an intraperitoneal route in patients with resected advanced gastric cancer. MATERIALS AND METHODS: Seventeen patients with resected advanced gastric cancer were entered onto the study. After completion of a curative resection and an astomosis, heptaplatin was administered intraperiton eally in one liter of 5% dextrose solution. The starting heptaplatin dose was 400 mg/m2 of the body surface area, and was escalated in 200 mg/m2 increments, to cohorts of three patients. A pharmacokinetic analysis was carried out to determine the total and ultrafiltratable platinum concentrations in the plasma, peritoneal fluid, and urine. RESULTS: Patients were unable to tolerate a 1, 000 mg/m2 dose level, and at 800 mg/m2, reVersible Grade III toxic ities, including elevated creatinine, proteinuria, hypon- atremia, abdominal pain, and intraabdominal bleeding were noted. No significant toxicity was noted up to a 600 mg/m2 dose level. The ratio of the peak peritoneal to peak plasma drug concentrations were 19.4, 16.6 and 22.8 at doses of 400 mg/m2, 600 mg/m2 and 800 mg/m2, respectively. The pharmacological advantage, expressed as the peritoneal to plasma AUC ratio ranged from 4.3 to 7.0. CONCLUSION: Heptaplatin can be delivered by an intra peritoneal route, with both an acceptable toxicity profile and a major pharmacokinetic advantage for cavity exposure. The MTD of intraperitoneal heptaplatin was 800 mg/m2. The major DLTs were nephrotoxicity and intraabdominal bleeding. The recommended starting dose for a subsequent study would be 600 mg/m2.

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Amplification and Overexpression of c-erbB-2 in Gastric Cancer: Si Youl Jun, Ho Young Chung, Seung Cheol Lee, Tae Lin Huh, Wansik Yu; J Korean Cancer Assoc. 2000;32(3):467-475.

Abstract PDF: PURPOSE
We compared c-erbB-2 oncogene amplification and oncoprotein expression, trying to identify the biologic and prognostic significance of c-erbB-2 in adendegrees Carcinoma of the stomach.
MATERIALS AND METHODS
Formalin-fixed, paraffin-embedded tissue sections from 43 cases of gastric cancer were analyzed for amplification of c-erbB-2 by differential polymerase chain reaction and for overexpression of gene product by immunohistdegrees Chemistry.
RESULTS
The amplification was detected in 13 cases (30%). Enhanced c-erbB-2 immunoreactivity was observed in 30% (13/43) of tumors. Tumors with gene amplification generally stained strongly (p=0.003). Although the frequency of amplification and overexpression of c-erbB-2 was increased with advanced gastric cancer and with lymph node metastasis, this difference was not statistically significant. c-erbB-2 gene amplification or protein overexpression showed a trend toward a better five year survival rate, but this did not reach a statistical significance.
CONCLUSION
Amplification and/or overexpression of the c-erbB-2 may be of value in clarifying the biologic characteristics of the human gastric cancer. However, more sensitive and more speci fic methods of identifying gene amplification are needed and the standardization of the staining method as well as guidelines for interpreting the staining result are mandatory for this purpose.

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Comparison of Old and New TNM Classification of Gastric Cancer: Wan Sik Yu, Ho Young Chung, In Soo Suh; J Korean Cancer Assoc. 1999;31(5):939-945.

Abstract PDF: PURPOSE
We analyzed the appropriateness of the changes regarding the classification of gastric cancer in the fifth edition of the UICC TNMclassification of malignant tumors.
MATERIALS AND METHODS
Gastrectomy was performed in 727 patients with gastric cancer between 1990 and 1994. The pN, pM and stage of each patient was reclassified according to the 5th edition. The previous and present pN, pM and stage of each patient were compared.
RESULTS
Although ten cases of pNO were reclassified as pNX because the number of dissected regional lymph nodes was less than 15, there revealed a good correlation between old and new pN classification. Survival distribution according to the old pN classification identified significant differences among subgroups of patients. And this was true for the new pN classification. Nine pM1 patients who had involved hepatoduodenal lymph node were reclassified into pMO. Although 97 patients were down-staged and 30 patients were up-staged, comparison of stage according to two classifications revealed good correlation. Both survival distributions according to the new and old stage grouping identified significant differences among subgroups of patients.
CONCLUSION
The classification of lymph node metastasis and stage grouping in gastric cancer should be more scientific and rational in future revisions.

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