Neoplasms

Digestive System Diseases

All Conditions

Symptoms and General Pathology

Nutritional and Metabolic Diseases

Rare Diseases

Esophageal Neoplasms

Body Weight

Weight Loss

Nutrition Disorders

Esophageal Cancer

Patients who's peroperative BMI is less than the 10th centile

Patients who's peroperative BMI equals or is greater than the 10th centile

Esophagectomy for cancer is often accompanied with severe preoperative weight loss. Body Mass Index (BMI) values are age-independent and the same for both sexes. From the perspective that these two parameters should actually be taken into account too, we developed a model to calculate "age-gender specific BMI-percentiles" (AG-BMI) and tested this model in relation to survival outcome after esophagectomy for cancer.

Age-Gender specific BMI percentiles are more accurate compared to the current BMI classes in predicting Overall Survival (OS) after esophagectomy for cancer. Furthermore we believe in a more devastating impact on OS from underweight and not from overweight.

By preoperatively identifying risk patients for poorer OS, especially the non-tumoral deaths, this can be a tool to tailor postoperative nutritional strategies to counter further weight loss and bringing postoperative weight to normal ranges.

Age and Gender Corrected Body Mass Index

Age and Gender Corrected Body Mass Index: When Preoperative Weight Loss and Underweight Are Becomming Clinically Significant in Esophagectomy for Cancer.

Overall 5-year survival after esophagectomy for cancer

University Hospital, Gasthuisberg

Datamanager Thoracic Surgery

Stomach Neoplasms

Malnutrition

Body Weight Changes

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Stomach Diseases

Head and Neck Neoplasms

Esophageal Diseases

Stomach Cancer

All Drugs and Chemicals

Gastrointestinal Agents

Hormones

Glucagon

Glucagon-Like Peptide 1

Serial assessment:

Fasting gut hormones, post-prandial gut hormone response to a standardized 400kcal meal

Used to assess post-prandial gut hormone response pre-operatively and at 10 days, 4 weeks, 6 months and 12 months post-operatively.

Standardized 400kcal semi-liquid meal

John V Reynolds, MCh, FRCS

Surgery is the cornerstone of treatment for patients with oesophageal or gastric cancer, but while surgical removal of the tumour (oesophagectomy or gastrectomy) may offer the best chance of cure, these are major operations associated with specific long term complications. Weight loss and poor nutrition are relatively common problems among patients who attain long-term cancer remission and cure after surgery. The mechanisms underlying these problems are not well understood and therefore treatment options are limited.

The investigators research has demonstrated increased levels of chemical messengers (gut hormones) released from the gastrointestinal tract after meals in patients who have previously undergone upper gastrointestinal surgery. These chemical messengers play a role in signalling the feeling of fullness during and after a meal (satiety). Understanding the mechanisms involved in increased gut hormone secretion after these operations may allow us to use certain medications to block gut hormone release and hence reduce satiety allowing patients to eat more, regain weight and prevent nutritional complications after surgery.

Exaggerated post-prandial satiety gut hormone responses following oesophagectomy have, however, only been established cross-sectionally and therefore the time course for development of increased gut hormone secretion is unknown. Data collected from this study will provide important information about optimal timing of therapeutic intervention in this patient group, while offering mechanistic insights with regard to the pathophysiologic process underlying post-operative early satiety.

Longitudinal Assessment of Gut Hormone Secretion Following Upper Gastrointestinal Surgery for Cancer

University College Dublin

University of Dublin, Trinity College

St. James's Hospital, Ireland

Surgical Research Fellow

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Age and Gender Corrected Body Mass Index	NCT01958697	Esophageal Canc...		18 Years - 95 Years	University Hospital, Gasthuisberg
Longitudinal Assessment of Gut Hormone Secretion Following Upper Gastrointestinal Surgery for Cancer	NCT02385630	Esophageal Neop... Stomach Neoplas... Weight Loss Malnutrition	Standardized 40...	18 Years -	St. James's Hospital, Ireland

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