Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery

  • Lee, Tae-Hoon (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Lee, Chang Min (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Park, Sungsoo (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Jung, Do Hyun (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Jang, You Jin (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Kim, Jong-Han (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Park, Seong-Heum (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Mok, Young-Jae (Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine)
  • Received : 2017.07.24
  • Accepted : 2017.10.26
  • Published : 2017.12.31
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Abstract

Purpose: This study primarily aimed to investigate the short- and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission. Materials and Methods: We retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012. Results: T2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not. Conclusions: All types of gastric cancer surgery can be effective in short- and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.

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