Effects of an oral elemental nutritional supplement in Gastric Cancer Patients after Gastrectomy.

Abstract

Introduction：We investigated the effects of an oral elemental nutritional supplement（ELENTALⓇ：ED）on weight loss in the early and long-term postoperative periods and on skeletal muscle mass loss（KSES-001, 002, and 003 studies）. Methods：One hundred eleven gastric cancer patients who underwent R0 total gastrectomy（TG）or distal gastrectomy（ DG）were randomized into two groups：an ED group of 58 patients who received an elemental nutritional supplement（ 300 kcal/day）in addition to usual diet for 6-8 weeks after surgery, and a control group（C group, 53 patients） who received only their usual diet. The weight loss rates were compared 6-8 weeks and one year postoperatively. In addition, lumbar skeletal muscle area at the L3 level preoperatively and 1 year postoperatively was measured using SYNAPSE VINCENT to compare the rate of skeletal muscle loss. Results：The rate of weight loss in the early postoperative period was ED 4.9％/C 6.6％, significantly suppressing the rate of weight loss（P=0.047）. There was a significant difference of ED 5.0％/C 9.1％ after TG（P=0.012）, but no difference after DG. The weight loss rate at 1 year after surgery was ED 7.1％/C 9.1％, with no difference（P=0.171）. Although, there was a significant difference of ED 9.7％/C 15.1％ after TG（P=0.015）. The rate of skeletal muscle loss at 1 year after surgery was ED 8.0％/C 10.1％（P=0.357）overall；after TG；ED 12.5％/C 17.5％（P=0.196）and after DG； ED 5.6％/C 6.2％（P=0.770）, all without significant difference. Conclusion：An oral elemental nutritional supplements early after gastrectomy significantly reduced short-term postoperative weight loss, and in TG, also significantly reduced weight loss at 1 year postoperatively. No significant difference in skeletal muscle loss was detected.