Efficiency of the rehabilitation program for cancer patients who underwent radical surgery for gastric cancer. Pilot study.

BACKGROUND:Surgical intervention is accompanied by an increase in catabolic processes. Medical rehabilitation helps restore functional status, but is not always well tolerated by patients with malnutrition. AIM: To evaluate the impact of rehabilitation (special moderate intensity exercises and high protein oral nutritional supplements (ONS) with omega-3 fatty acids (FA)) on the functional and nutritional status of patients after radical surgery for gastric cancer (GC) (gastrectomy, D2 lymph node dissection). METHODS: A prospective observational single-center study included 40 patients with gastric cancer (m:f = 23:17), 56-73 years, who had undergone radical surgery no more than 30 days earlier. The rehabilitation lasted 14 days; included exercises and ONS (Supportan drink, 400 ml per day). Moderate-intensity aerobic training and weight exercises were conducted under supervision five times a week; two days a week, patients exercised independently. Data on all food and drink consumed by patients during the day before and after the rehabilitation were collected and recorded. The intake of energy, protein, and fluid was calculated using calorie tables. Body weight loss (BWL) over the six months ago and in the early postoperative period, body mass index (BMI), mid-arm muscle circumference (MAMC) were assessed. The 6-minute walk test (6MWT), hand-grip dynamometry, assessment of anxiety and depression by HADS were performed before and after of the rehabilitation. The results are presented as mean ± standard deviation. Differences were considered significant at p ≤ 0.05. Results: Preoperative BWL was 14.9±9.03%, postoperative BWL was 7.12±2.28% before inclusion in the study. The BW, hand-grip strength, and MAMC increased during the study: 26.77±0.82 vs 24.38±0.85 cm, 34.52±2.2 vs 27.95±2.1 kg, 380.74±15.26 vs 437.18±19.75 m, respectively (for all indicators p0.05). The protein intake increased from 0.86±0.19 to 1.39±0.18 g/kg BW/day. The level of anxiety and depression significantly decreased from 11.35±1.15 to 8.08±1.12 points, from 12.5±1.2 to 9.08±1.1 points, respectively, p0.05. Conclusions: The rehabilitation program (special moderate intensity physical exercises under the supervision), supplemented by high protein ONS with omega-3 FA, has a positive effect on the functional, psychological and nutritional status of radically operated patients with GC.