title: Effectiveness of a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer.
abstract: We established a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. Twenty-two gastric cancer patients aged 65 years or older with a diagnosis of sarcopenia according to the algorithm proposed by the European Working Group on Sarcopenia in Older People received our preoperative program. The median duration of the program participation was 16 days. Total calorie and protein intakes were significantly higher after the program than before [29.4 ± 6.9 kcal/kg ideal body weight (IBW) vs 27.3 ± 5.6 kcal/kg IBW, p = 0.049, and 1.3 ± 0.4 g/kg IBW vs 1.1 ± 0.3 g/kg IBW, p = 0.0019, respectively]. Handgrip strength significantly increased after the program (21.2 ± 5.2 kg vs 20.0 ± 5.3 kg, p = 0.022). Likewise, gait speed and skeletal muscle mass index increased, although the differences did not reach statistical significance. Four patients became nonsarcopenic after the program. Postoperative complications were observed in three patients (13.6%); however, none of these complications were severe (Clavien-Dindo grade III or lower). A preoperative exercise and nutritional support program has the potential to reduce sarcopenia and improve postoperative outcome in elderly sarcopenic patients with gastric cancer.
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan. kazuyoshi0208yamamoto@yahoo.co.jp.|Department of Surgery, NTT West Osaka Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka, 543-8922, Japan. kazuyoshi0208yamamoto@yahoo.co.jp.
authors.forename: Kazuyoshi
authors.identifier: http://orcid.org/0000-0002-7645-2412
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Food and Nutrition, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nagatsuma
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.|Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Fukuda
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.affiliation: Department of Surgery, Osaka General Medical Center, Osaka, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.affiliation: Department of Surgery, Osaka General Medical Center, Osaka, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Fujitani
authors.affiliation: Department of Surgery, Kaizuka City Hospital, Osaka, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Tsujinaka
mesh_terms: D000368:Aged; D000465:Algorithms; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology; D018529:Nutritional Support / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D055948:Sarcopenia / Q000209:etiology / Q000628:therapy*; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Exercise; Nutritional support; Preoperative care; Sarcopenia; Stomach neoplasms