Risk Factors for Body Weight Loss After Gastrectomy for Gastric Cancer Analyzed From the JCOG1001 Phase III Trial

Aim To investigate the factors associated with BWL after gastrectomy using data from the phase III trial (JCOG1001). Methods This post hoc analysis included 728 patients from the JCOG1001. The percentage of BWL (%BWL) was defined as the proportion of decrease in body weight immediately before adjuvant chemotherapy initiation compared with that before surgery. Background, surgery, and postoperative data were compared between patients with and without a %BWL ≥ 10. The impact of each factor for a %BWL ≥ 10 was calculated using logistic regression analysis. Results %BWL ≥ 10 was observed in 258 (35.4%) patients. Male sex, preoperative body mass index (BMI) ≥ 25, total gastrectomy, operation time ≥ 238 min, intraoperative blood loss ≥ 285 mL, and postoperative complications were more frequent among patients with %BWL ≥ 10. Using multivariable analysis, a preoperative BMI ≥ 25 (odds ratio [OR] 1.870, 95% confidence interval [CI] 1.267–2.762, p < 0.01), total gastrectomy (vs. distal) (OR 3.252, 95% CI 2.291–4.617, p < 0.01), and grade 2–4 postoperative complications (vs. grade 0–1) (OR 3.229, 95% CI 2.192–4.756, p < 0.01) were independent risk factors for a %BWL ≥ 10. Conclusion High preoperative BMI, total gastrectomy, and/or postoperative complications were risk factors for postoperative BWL ≥ 10% after gastrectomy for gastric cancer. Trial Registration The JCOG1001 was registered with UMIN‐CTR, under the number UMIN000003688