637P - Evaluation of oral, nutritional support on postoperative body weight in gastric cancer patients receiving elemental diet: A randomized study

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Gastric Cancer
Supportive Measures
Presenter Ryohei Kawabata
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors R. Kawabata1, K. Nishikawa2, K. Kishi3, K. Inoue4, J. Matsuyama5, Y. Akamaru6, Y. Kimura7, S. Tamura8, J. Kawada9, Y. Fujiwara3, T. Kawase7, J. Fukui4, M. Takagi9, A. Takeno10, T. Shimokawa11, H. Imamura12
  • 1Surgery, Osaka Rosai Hospital, 591-8025 - Sakai/JP
  • 2Surgery, Osaka National Hospital, 5400006 - Osaka/JP
  • 3Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka/JP
  • 4Surgery, Kansai Medical University, Hirakata/JP
  • 5Department Of Surgery, Yao Municipal Hospital, Yao/JP
  • 6Surgery, Japan Community Health care Organization Osaka Hospital, Osaka/JP
  • 7Surgery, Sakai City Hospital, Sakai/JP
  • 8Surgery, Kansai Rosai Hospital, 660-8511 - Amagasaki/JP
  • 9Surgery, Osaka General Medical Center, Osaka/JP
  • 10Surgery, Kansai Rosai Hospital, Amagasaki/JP
  • 11Regional Social Management, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi/JP
  • 12Surgey, Toyonaka Municipal Hospital, Toyonaka/JP



Postoperative weight loss causes deterioration in the patient's quality of ife and influences long-term prognosis in gastric cancer patients who have undergone gastrectomy. Moreover, recent retrospective studies indicated postoperative weight loss as a risk factor for premature interruption of S-1 adjuvant chemotherapy. In this prospective randomized controlled study, we aimed to examine whether the early institution of nutritional support comprising an oral elemental diet (ED) prepared for post-gastrectomy patients with depressed digestive/absorptive function would help prevent postoperative weight loss until the initiation of S-1 treatment.


After surgery, patients were randomly assigned to the ED or control groups. The groups were divided according to the surgical methods used (total/distal gastrectomy), clinical stage of disease, and patients' body mass index(<18.5/ ≥ 18.5). In the ED (ElentalTM) group, 300kcal of ED was provided in addition to a regular diet from the day the patient started a soft rice diet or a regular diet for 6-8 weeks. The primary endpoint was the percentage of body weight loss (%BWL) from the pre-surgical body weight to that at 6-8 weeks after the day starting diet. Moreover, the nutrition-related blood parameter changes and adverse effects were evaluated.


The study included 112 patients from eight hospitals. There was a significant difference in the percentage of body weight loss (%BWL) between the ED and control groups (4.86 ± 3.72% and 6.60 ± 4.90%; p = 0.047). Multivariate analysis demonstrated ED treatment, surgery type and performance status as independent factors that affect body weight changes. No significant differences were observed in hematological and non-hematological adverse events, between the two groups.


The oral ED product can prevent postoperative weight loss in gastric cancer patients undergoing gastrectomy.


All authors have declared no conflicts of interest.