Preoperative bone mineral density in gastric cancer patients.

BACKGROUND/AIMS: It has been reported that there is a high rate of bone mineral density (BMD) loss after gastrectomy for gastric cancer. To clarify the course of postoperative BMD loss, it is necessary to precisely determine the preoperative BMD of gastric cancer patients. METHODOLOGY: From October 2005 through September 2008, preoperative BMD was measured in 91 patients (59 males and 32 females, mean age of the patients was 67.3 years) who underwent gastrectomy for gastric cancer. Then, the percentage of the subject's BMD divided by the BMD of young adult mean (YAM) (% of YAM) was obtained for each subject and the incidence of osteoporosis as well as the relationship between % of YAM and the patient's clinico-pathological factors or biochemical parameters was examined. RESULTS: The incidence of osteoporosis was 15.4%. There is a correlation between BMD in preoperative gastric cancer patients and serum albumin levels, and BMD decreases further in the elderly and individuals with a BMI lower than 18.5. CONCLUSIONS: From the viewpoint of osteoporosis prevention, this suggests the importance of nutritional management for elderly gastric cancer patients with associated nutritional disorder.

Additional Surgery After Non-curative Resection of ESD for Early Gastric Cancer.

AIM: The appropriate additional surgery after non-curative resection of Endoscopic Mucosal Resection (ESD) for early gastric cancer is herein discussed. PATIENTS AND METHODS: Data on 54 patients after non-curative resection of ESD were evaluated. These patients were broadly classified according to the risk of lymph node metastasis with lesions into group A (without risk) (n=26) and group B (with risk) (n=28). Their treatment results were evaluated. RESULTS: The incidence of residual lesion was 7.7% in group A and 14.3% in group B. Risk factors were piecemeal resection, involvement of the horizontal margin (HM1) or unclear involvement of the horizontal margin (HMX) and with ulceration. Lymph node metastasis was detected in one patient with lymphatic invasion, total diameter of 3 cm or more and submucosal invasion over 0.5 mm (SM2). The 5-year survival rate was 93% and none of the patients died of gastric cancer. CONCLUSION: Follow-up observation was reasonable in group A. Patients who are judged as having undergone piecemeal resection, HM1 or HMX and with ulceration, should be treated by additional surgery and patients judged with SM2 or total diameter of 3 cm or more or lymphatic invasion should be treated by additional surgery with lymphadectomy in group B.