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Risk of Dementia in Gastric Cancer Survivors Who Underwent Gastrectomy: A Nationwide Study in Korea

  • Health Services Research and Global Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to compare the risk of dementia, including Alzheimer’s disease (AD) and vascular dementia (VaD), between gastric cancer patients who underwent gastrectomy and the general population.

Methods

All patients (n = 63,998) aged ≥ 50 years who received a diagnosis of gastric cancer and underwent curative gastrectomy between 2007 and 2012 and a noncancer control population (n = 203,276), matched by age and sex, were identified from the Korean National Health Insurance Services and traced until 2017. Hazard ratios and 95% confidence intervals for dementia were calculated with a Cox regression analysis.

Results

Gastric cancer patients who received a gastrectomy showed an increased risk of AD [adjusted hazard ration (aHR) 1.08, 95% confidence interval (CI) 1.03–1.14], and the risk was especially marked for those who received a total gastrectomy (aHR 1.39, 95% CI 1.25–1.54). Gastric cancer survivors showed a decreased risk for VaD (aHR 0.85; 95% CI 0.73–0.98) regardless of operation type. Those who received continual vitamin B12 supplementation after a total gastrectomy were less likely than controls to develop AD (aHR 0.71; 95% CI 0.54–0.92).

Conclusions

Compared with controls, gastric cancer patients who received a total gastrectomy had an increased incidence of AD and a decreased risk of VaD. Our results suggest that vitamin B12 deficiency might play a role in the development of AD and highlight the need for vitamin B12 supplementation after total gastrectomy.

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Acknowledgment

This study received general research support from Samsung Medical Center.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Dong Wook Shin and Yong Gyu Park have contributed to this work equally as co-corresponding authors.

Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Yoon Jin Choi MD, PhD & Dong Ho Lee MD, PhD

  2. Department of Family Medicine and Supportive Care Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Dong Wook Shin MD, Dr PH, MBA

  3. Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea

    Wooyoung Jang MD

  4. Department of Family Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea

    Su-Min Jeong MD

  5. Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea

    Sanghyun Park MS, Kyung-do Han PhD & Yong Gyu Park PhD

Authors
  1. Yoon Jin Choi MD, PhD
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  2. Dong Wook Shin MD, Dr PH, MBA
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  4. Dong Ho Lee MD, PhD
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Contributions

SDW and PYG designed the study. HKD and PS analyzed the data. CYJ, JW, and JS drafted the manuscript. LDH and PYG revised the article. All the authors read and revised the manuscript and approved its final version. SDW and PYG are responsible for the overall content as guarantors and accept full responsibility for the work and conduct of the study; they had access to all the data and controlled the decision to publish. The corresponding authors attest that all listed authors meet the authorship criteria and that no others meeting the criteria have been omitted, that they had full access to all the data in the study, and that they had final responsibility for the decision to submit for publication.

Corresponding authors

Correspondence to Dong Wook Shin MD, Dr PH, MBA or Yong Gyu Park PhD.

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Disclosure

No authors have conflicts of interest to report.

Research Involving Human Participants

The research committee of Helsinki University Hospital approved our study plan. Obtaining consent was not needed in our register-based study, because we did not contact any study patients or their caregivers.

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Choi, Y.J., Shin, D.W., Jang, W. et al. Risk of Dementia in Gastric Cancer Survivors Who Underwent Gastrectomy: A Nationwide Study in Korea. Ann Surg Oncol 26, 4229–4237 (2019). https://doi.org/10.1245/s10434-019-07913-8

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  • DOI: https://doi.org/10.1245/s10434-019-07913-8

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