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

IF 3.1 2区医学 Q2 ONCOLOGY Journal of Cancer Survivorship Pub Date : 2025-04-01 Epub Date: 2023-10-21 DOI:10.1007/s11764-023-01480-4

Yinning Guo, Yimeng Chen, Xueyi Miao, Jieman Hu, Kang Zhao, Lingyu Ding, Li Chen, Ting Xu, Xiaoman Jiang, Hanfei Zhu, Xinyi Xu, Qin Xu

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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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接受根治性胃切除术的老年癌症患者的BMI轨迹、与预后的关系和预测因素：一项前瞻性纵向观察研究。

目的：老年癌症根治性胃切除术患者容易出现意外的体重减轻。术前预测体重风险可能是预防体重减轻和改善预后的一种很有前途的方法。本研究旨在探讨老年癌症患者术后一年的BMI轨迹，评估其与预后的关系，并探讨其相关预测因素，为体重管理和预后改善提供依据。方法：纳入412例癌症患者，记录6个时间点的BMI。通过生长混合模型分析BMI的轨迹，并通过回归模型研究BMI轨迹与结果的相关性及其预测因素。结果：我们确定了3类BMI轨迹：“缓慢下降的BMI”、“快速下降的BMI）和“保持的BMI”。与1级相比，2级患者在1年内再次入院的频率更高（β = 0.59，95%置信区间：0.29，0.89，P 结论：我们的研究结果可为筛选预后不良的高危老年癌症患者、实施风险分层、制定准确的体重管理方案和改善预后提供依据。对癌症幸存者的启示：我们的研究结果可以为癌症幸存者提供基于预测因素的术前风险筛查，以便及时实施营养支持和体重管理，改善预后。

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来源期刊

Journal of Cancer Survivorship ONCOLOGY-

CiteScore

7.00

自引率

10.80%

发文量

149

审稿时长

>12 weeks

期刊介绍： Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.