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BMI trajectories, associations with outcomes and predictors in elderly gastric cancer patients undergoing radical gastrectomy: a prospective longitudinal observation study

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Abstract

Objectives

Elderly gastric cancer patients undergoing radical gastrectomy are prone to experience unexpected weight loss. Preoperative weight risk prediction may be a promising way to prevent weight loss and improve prognosis. The objectives of this study were to explore the BMI trajectory of elderly gastric cancer patients one year after surgery, evaluate theirs the association with outcomes, and explore their related predictors, so as to provide evidence for weight management and prognosis improvement.

Methods

412 gastric cancer patients were included and recorded BMI at 6 time points. The trajectories of BMI were analyzed by growth mixture modeling, and the associations of BMI trajectories with outcomes as well as their predictors were investigated by regression models.

Results

We identified 3 classes of BMI trajectories: the “slow-decreasing BMI”, “rapid-decreasing BMI” and “maintaining BMI”. Compared with class1, patients in class 2 were more likely to have a higher frequency of readmission within 1-year(β = 0.59, 95%CI: 0.29, 0.89, P < 0.001) and a higher rate of mortality within 1-year(β = 24.74, 95%CI: 9.60, 63.74, P < 0.001) ; patients in class 3 were more likely to have a higher quality of life (β=-10.46, 95%CI: -17.70, -3.22, P = 0.005) and fewer readmission times within one year (β=-0.43, 95%CI: -0.77, -0.09, P = 0.015). Predictors of decreasing BMI trajectories were TNM stage, comorbidity, anxiety, family cohesion and social support(P < 0.05).

Conclusions

Our findings can provide a basis for screening high-risk elderly gastric cancer patients with poor prognosis, implementing risk stratification, formulating accurate weight management programs and improving prognosis.

Implications for Cancer Survivors

The results of our study can provide gastric cancer survivors with preoperative risk screening based on predictive factors so that nutritional support and weight management can be implemented in a timely manner to improve prognosis.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the support from the National Natural Science Foundation of China and Jiangsu Higher Education Institution Research Project Contract for this study.

Funding

This study was supported by two projects: project “The exploration of trajectories and intervention program of frailty for gastric cancer survivors based on the health ecology theory” supported by the National Natural Science Foundation of China (NSFC) (No.82073407) and the Basic Science (Natural Science) of Jiangsu Higher Education Institution Research Project Contract (Project No. 22KJB320013).

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Authors and Affiliations

  1. School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, China

    Yinning Guo, Yimeng Chen, Xueyi Miao, Jieman Hu, Kang Zhao, Ting Xu, Xiaoman Jiang, Hanfei Zhu & Qin Xu

  2. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China

    Lingyu Ding & Li Chen

  3. Faculty of Health, Queensland University of Technology, Kelvin Grove Campus, Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia

    Xinyi Xu

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  1. Yinning Guo
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Yinning Guo, Yimeng Chen and Xueyi Miao. The first draft of the manuscript was written by Yinning Guo and Yimeng Chen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xinyi Xu or Qin Xu.

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Yinning Guo and Yimeng Chen contributed equally to this work and they are co-first authors.

Registration: ChiCTR2100052769

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Guo, Y., Chen, Y., Miao, X. et al. BMI trajectories, associations with outcomes and predictors in elderly gastric cancer patients undergoing radical gastrectomy: a prospective longitudinal observation study. J Cancer Surviv (2023). https://doi.org/10.1007/s11764-023-01480-4

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