Impact of body mass index on quality of life after distal gastrectomy for gastric cancer

PURPOSE: Few studies have evaluated changes in quality of life (QoL) in relation to changes in body mass index (BMI) after gastrectomy. This study aimed to evaluate the impact of postoperative changes in BMI on QoL after distal gastrectomy in gastric cancer patients. METHODS: QoL data from the European Organization for the Research and Treatment of Cancer (EORTC) gathered via the QLQ-C30 and QLQ-STO22 questionnaires were obtained from 1,036 patients preoperatively and at 1 year postoperatively. The patients were divided into 2 groups: group 1 - decreased postoperative BMI and group 2 - unchanged or increased postoperative BMI. RESULTS: There were 577 patients in group 1 and 459 in group 2. According to global health status and functional scales, emotional functioning (P = 0.035) was significantly worse in group 1 than in group 2 at 1 year postoperatively. Furthermore, there were significant decreases in QoL symptom scale scores, including fatigue (P = 0.016), nausea and vomiting (P = 0.002), and appetite loss (P = 0.001) scores, in group 1 compared with group 2. Regarding QLQ-STO22, reflux symptoms (P = 0.020), anxiety (P = 0.003), and body image (P = 0.003) were significantly worse in group 1 than in group 2 at 1 year after surgery. CONCLUSION: BMI changes after distal gastrectomy influence QoL. Focus on controlling gastrointestinal symptoms and providing psychological support is essential in patients with decreased BMI after surgery. Patients should be offered follow-up care to assist them in maintaining BMI, for example, through dietary-behavior modifications and via intensive nutritional support, to prevent QoL deterioration after distal gastrectomy.