Yasuhiro Miyazaki1, Takeshi Omori2, Kazumasa Fujitani3, Junya Fujita4, Ryohei Kawabata5, Hiroshi Imamura6, Kazuyuki Okada7, Jeong-Ho Moon8, Motohiro Hirao9, Jin Matsuyama10, Takuro Saito11, Tsuyoshi Takahashi11, Yukinori Kurokawa11, Makoto Yamasaki11, Shuji Takiguchi12, Masaki Mori13, Yuichiro Doki11. 1. Department of Gastroenterological Surgery, Osaka General Medical Center, 3-1-56, Bandaihigashi Sumiyoshi-ku, Osaka, 558-8558, Japan. ymiyazaki02@gh.opho.jp. 2. Osaka International Cancer Institute, Osaka, Japan. 3. Department of Gastroenterological Surgery, Osaka General Medical Center, 3-1-56, Bandaihigashi Sumiyoshi-ku, Osaka, 558-8558, Japan. 4. Sakai City Medical Center, Sakai, Japan. 5. Osaka Rosai Hospital, Sakai, Japan. 6. Toyonaka Municipal Hospital Osaka, Toyonaka, Japan. 7. Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan. 8. NTT West Osaka Hospital, Osaka, Japan. 9. National Hospital Organization Osaka National Hospital, Osaka, Japan. 10. Yao Municipal Hospital, Yao, Japan. 11. Osaka University Graduate School of Medicine, Osaka, Japan. 12. Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 13. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Abstract
BACKGROUND: Body weight loss (BWL) after gastrectomy is associated with not only a deteriorated quality of life but also a poor prognosis. Oral nutritional supplements (ONS) may be used to minimize BWL, which is observed in the first 3 months after gastrectomy and becomes stable thereafter, although the results of several randomized trials remain controversial. METHODS: We performed a multicenter, open-label randomized controlled trial including 1003 gastric cancer patients undergoing curative gastrectomy. Patients were assigned to the ONS group or the control group. In the former, 400 ml (400 kcal) per day for 12 weeks as enteral nutrition was planned, and the actual intake amount was recorded daily by patients themselves. The primary endpoint was BWL 1 year after gastrectomy. RESULTS: BWL data were available in 880 patients (ONS 437, control 443). BWL at 3 months was significantly lower in the ONS group than in the control group (7.1 ± 5.6% and 8.5 ± 5.8%, p = 0.0011). However, the difference gradually declined after 6 months and was not significant 1 year after surgery (9.3 ± 8.2% and 9.8 ± 8.7%, p = 0.37). In the ONS group, 50.4% of patients took more than 200 ml/day of ONS (average 301 ml) and showed significantly less BWL (8.2 ± 7.2%) at 1 year than the control (p = 0.0204). CONCLUSION: The administration of ONS for 12 weeks after gastrectomy did not improve BWL at 1 year. However, the improvement in BWL remained until 1 year after surgery in patients who took more than 200 kcal/day of ONS.
BACKGROUND: Body weight loss (BWL) after gastrectomy is associated with not only a deteriorated quality of life but also a poor prognosis. Oral nutritional supplements (ONS) may be used to minimize BWL, which is observed in the first 3 months after gastrectomy and becomes stable thereafter, although the results of several randomized trials remain controversial. METHODS: We performed a multicenter, open-label randomized controlled trial including 1003 gastric cancer patients undergoing curative gastrectomy. Patients were assigned to the ONS group or the control group. In the former, 400 ml (400 kcal) per day for 12 weeks as enteral nutrition was planned, and the actual intake amount was recorded daily by patients themselves. The primary endpoint was BWL 1 year after gastrectomy. RESULTS: BWL data were available in 880 patients (ONS 437, control 443). BWL at 3 months was significantly lower in the ONS group than in the control group (7.1 ± 5.6% and 8.5 ± 5.8%, p = 0.0011). However, the difference gradually declined after 6 months and was not significant 1 year after surgery (9.3 ± 8.2% and 9.8 ± 8.7%, p = 0.37). In the ONS group, 50.4% of patients took more than 200 ml/day of ONS (average 301 ml) and showed significantly less BWL (8.2 ± 7.2%) at 1 year than the control (p = 0.0204). CONCLUSION: The administration of ONS for 12 weeks after gastrectomy did not improve BWL at 1 year. However, the improvement in BWL remained until 1 year after surgery in patients who took more than 200 kcal/day of ONS.
Authors: H Friess; J Böhm; M W Müller; B Glasbrenner; R L Riepl; P Malfertheiner; M W Büchler Journal: Am J Gastroenterol Date: 1996-02 Impact factor: 10.864