Abstract
Introduction
Patients with advanced gastric adenocarcinoma are at high risk of malnutrition. Some
patients benefit from total gastrectomy associated with hyperthermic intraperitoneal
chemotherapy (HIPEC) with or without cytoreduction surgery (CR) as a curative strategy.
The aim of this study was to describe pre- and post-operative nutritional assessments
and their impact on survival in these patients.
Materials and methods
All patients with advanced gastric adenocarcinoma treated with gastrectomy and HIPEC
with or without CR at Lyon University Hospital were retrospectively included from
April 2012 to August 2017. Carcinologic data, history of weight, anthropometric measures,
nutritional biological markers and CT-scan body composition were collected.
Results
54 patients were included. Malnutrition affected 48.1% before and 64.8% after surgery,
and severe malnutrition respectively 11.1% and 20.3%. Pre-operative sarcopenia diagnosed
by CT scan was found in 40.7% of the patients while 81.1% of the sarcopenic patients
had a normal or high body mass index. A loss of ⩾ 20% of usual weight on discharge
was a pejorative factor of survival at 3 years of follow-up (p = 0.0470). Only 14.8%
of the patients continued artificial nutrition following discharge but artificial
nutrition was resumed in 30.4% of the patients within 4 months after discharge owing
to weight loss.
Conclusions
Patients with advanced gastric adenocarcinoma undergoing gastrectomy and HIPEC with
or without CR are at high risk of malnutrition. Post-operative weight loss has a pejorative
impact on outcome. These patients should be systematically screened for malnutrition
with early interventionist nutritional care and close nutritional follow-up.
Keywords
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Article info
Publication history
Published online: March 30, 2023
Accepted:
March 27,
2023
Received in revised form:
February 9,
2023
Received:
June 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
