Korean Journal of Family Medicine

"Stomach Neoplasms"

Review Article

Nutritional pathways from treatment to management of sarcopenia in patients with gastric cancer: a narrative review: Swati , Mahak Sharma, Mohit Agarwal, Divya Choudhary; Korean J Fam Med 2026;47(2):97-108. Published online March 20, 2026; DOI: https://doi.org/10.4082/kjfm.25.0215

Abstract
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Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, represents a significant clinical concern among patients undergoing gastric cancer surgery. Postoperative individuals are particularly vulnerable due to gastrointestinal dysfunction, reduced nutrient intake, systemic inflammation, and treatment-induced metabolic stress. This condition is associated with higher complication rates, delayed recovery, chemotherapy intolerance, and decreased survival, underscoring the importance of early detection and effective nutritional management. This narrative review integrates and synthesizes recent evidence from clinical and experimental studies that explore the pathophysiology, diagnosis, and nutritional management of sarcopenia in gastric cancer. The review emphasizes key nutritional risk factors, assessment tools, and intervention strategies applicable to both preoperative and postoperative care. Validated methods such as SARC-F (strength, assistance with walking, rise from a chair, climb stairs, and falls), dual-energy X-ray absorptiometry, and computed tomography imaging play central roles in identifying muscle loss and functional decline. Evidence suggests that protein-enriched diets, branched-chain amino acids, omega-3 fatty acids, and micronutrients such as vitamin D and antioxidants help preserve muscle mass and improve recovery outcomes. Exercise and rehabilitation further enhance these benefits by synergistically promoting muscle protein synthesis and function. Moreover, emerging technologies—including artificial intelligence–assisted nutritional monitoring, nutrigenomics, and biomarker-based personalization—represent promising directions for individualized care. Sarcopenia in gastric cancer is a modifiable and clinically significant condition. Integrating personalized nutrition with structured rehabilitation can markedly enhance functional recovery, treatment tolerance, and quality of life. Future research should aim to develop precision-based nutritional algorithms and standardized diagnostic frameworks to optimize outcomes in this high-risk population.

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Original Articles

Factors Associated with Fatigue in Korean Gastric Cancer Survivors: Wan Park, Jung-Kwon Lee, Cho-Rong Kim, Jin-Young Shin; Korean J Fam Med 2015;36(6):328-334. Published online November 20, 2015; DOI: https://doi.org/10.4082/kjfm.2015.36.6.328

Abstract
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Background

Gastric cancer is the second most common cancer in Korea. Fatigue is a common symptom among cancer survivors. The aim of this study was to identify factors associated with fatigue in gastric cancer survivors.

Methods

Data were analyzed from 199 gastric cancer survivors who visited a cancer survivor outpatient clinic from July 2013 to June 2014. Patients were surveyed using a questionnaire containing a fatigue severity scale (FSS) and questions regarding associated symptoms. Participants were divided into fatigue (FSS) and non-fatigue groups based on FSS scores (≥4 and <4, respectively). Age, sex, weight, body mass index, cancer stage, pathology, surgery type, chemotherapy, radiotherapy, comorbid disease, family history of cancer, smoking, alcohol consumption, exercise, and laboratory results were investigated.

Results

The fatigue and non-fatigue groups contained 42 and 157 survivors, respectively. Their mean age was 58 years, and the mean post-operative period was 6.58 years. Arthralgia (odds ratio [OR], 12.95; 95% confidence interval [CI], 3.21-52.34), dyspnea (OR, 10.54; 95% CI, 2.94-37.80), dyspepsia (OR, 8.26; 95% CI, 2.63-25.96), changed bowel habits (OR, 4.56; 95% CI, 1.09-19.11), anemia (OR, 3.18; 95% CI, 1.26-8.05), and regular exercise (OR, 0.31; 95% CI, 0.12-0.77) were significantly associated with fatigue in gastric cancer survivors, while weight, treatment, and depressive mood were not.

Conclusion

Arthralgia, dyspnea, dyspepsia, bowel habit change, anemia, and regular exercise are associated with fatigue in gastric cancer survivors.

Citations

Citations to this article as recorded by

The trajectories and predictors of cancer-related fatigue in gastric cancer patients during chemotherapy: A longitudinal study using growth mixture modeling
Feifei Zhang, Qingfeng Wang, Hong Chen, Zhuyue Li, Xiaolian Jiang
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Cancer Related Fatigue and its Association with Depression and Anxiety in the Patients with Advanced Gastric Cancer
C R Akshatha, Yadav Nisha, Meenatchi H, Vikas Menon, Smita Kayal, Biswajit Dubashi
Journal of Gastrointestinal Cancer.2026;[Epub] CrossRef
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Resilience and positive affect contribute to lower cancer‐related fatigue among Chinese patients with gastric cancer
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Journal of Clinical Nursing.2018;[Epub] CrossRef
Validation of the Amharic Version of the Brief Fatigue Inventory for Assessment of Cancer-Related Fatigue in Ethiopian Cancer Patients
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Journal of Pain and Symptom Management.2018; 56(2): 264. CrossRef

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A hospital based case control study on the risk factors of stomach cancer.: Jae Ik Bae, Yun Mi Song, Jun Hyeon Yoo; J Korean Acad Fam Med 2001;22(4):539-547. Published online April 1, 2001

Abstract
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Background
: For gastric cancer, primary prevention by risk factor modification might have some important roles. However, previous studies having investigated the factors associated with stomach cancer reported various results. In addition, there were only a few studies based on Korean population.

Methods : A case-control study was carried out on 106 cases matched for age and sex with 106 controls in a tertiary care hospital. In patients who were aged 75 years or less and had been newly diagnosed as adenocarcinoma of stomach between July 1996 and January 1997 were included into the case group. Information on baseline characteristics, health habits, dietary habits of study subjects was obtained through an interview using structured questionnaire. Conditional logistic regression analysis was used to evaluate the factors associated with stomach caner.

Results : Salt preference was associated with significantly increased risk of stomach cancer(odds ratio[OR]=9.81, 95% confidence interval[CI]=2.28-42.2). Eating broiled food more than three times a week significantly increased the risk of stomach cancer (OR=3.33, 95% CI=1.16-9.55) compared to eating it less than once a week. Blood type, family history of stomach cancer, smoking, and alcohol consumption were not associated with stomach cancer.

Conclusion : Salt preference and frequent eating of broiled food are the risk factors significantly associated with stomach cancer in this study subjects.