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Gastrectomy for Early Gastric Cancer is Associated with Decreased Cardiovascular Mortality in Association with Postsurgical Metabolic Changes

 Yong-ho Lee  ;  Seung Jin Han  ;  Hyeon Chang Kim  ;  Woo Jin Hyung  ;  Joon Seok Lim  ;  Kwangsuk Lee  ;  Hyun Joo Lee  ;  Eun Young Lee  ;  Eun Seok Kang  ;  Chul Woo Ahn  ;  Bong Soo Cha  ;  Hyun Chul Lee 
 ANNALS OF SURGICAL ONCOLOGY, Vol.20(4) : 1250-1257, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality* ; Carotid Intima-Media Thickness/mortality* ; Cohort Studies ; Female ; Follow-Up Studies ; Gastrectomy/mortality* ; Humans ; Lipid Metabolism* ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications* ; Prognosis ; Risk Factors ; Stomach Neoplasms/complications ; Stomach Neoplasms/mortality* ; Stomach Neoplasms/surgery ; Survival Rate ; Young Adult
Gastric Bypass ; Cardiovascular Mortality ; Early Gastric Cancer ; Standardize Mortality Ratio ; Gastric Resection
Bariatric surgery effectively induces weight loss and resolves cardiovascular comorbidities in obese patients. We investigated cardiovascular and all-cause mortality in patients who underwent gastrectomies for early gastric cancer (EGC) and analyzed the changes in metabolic parameters after surgery.
A total of 2,477 patients who underwent gastrectomies for EGC between 1995 and 2004 were enrolled in the study and followed for mortality through 2007. Standardized mortality ratios (SMRs) were calculated using sex- and age-matched mortality in the general Korean population in 2005. Effects of gastrectomy on changes in body weight and metabolic parameters were investigated in 51 of the patients before and after surgery.
During the 15,096.4 person-years of follow-up, 244 deaths were recorded. The all-cause mortality was not significantly different from that of the general population (SMR [95 % confidence interval (CI)] = 1.01 [0.89 - 1.14]); however, cardiovascular mortality was significantly lower (SMR = 0.35 [0.22 - 0.53]). In the 51 patients included in the second part of the study, significant reductions in body weight and visceral fat areas occurred after surgery, regardless of whether the patients were previously obese. Triglycerides, LDL-cholesterol, and plasminogen activator inhibitor-1 levels were significantly decreased, whereas HDL-cholesterol and adiponectin levels were increased. Carotid intima-media thickness also was significantly decreased in previously obese and nonobese patients.
Patients with EGC who undergo gastrectomy have a lower cardiovascular mortality but similar all-cause mortality as that of the general population. In these patients, a significant reduction in body weight and visceral fat after surgery may improve impaired lipid metabolism and prevent atherosclerotic changes.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Eun Young(이은영)
Lee, Hyun Joo(이현주)
Lee, Hyun Chul(이현철)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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