1.The Influence of Lifestyle Behaviors and Body Mass Index Changes on Long-term Outcomes After Gastric Cancer Surgery: A Population-Based Cohort Study
Ju-Hee LEE ; Jiyeong KIM ; Dong-Gyu LEE
Journal of Gastric Cancer 2025;25(2):356-369
Purpose:
The present study investigated the impact of lifestyle behaviors and body mass index (BMI) on late recurrence, gastric remnant cancer (GRC), and long-term survival after curative gastrectomy.
Materials and Methods:
This retrospective study utilized data from the Korean National Health Insurance claims database. Among 71,014 patients with gastric cancer who underwent curative gastrectomy between January 2009 and December 2012, 23,359 remained cancerfree for five years. Of these, 7,735 patients with health examination data within 2 years before surgery and 5 years after surgery were analyzed for lifestyle behaviors, including smoking, alcohol consumption, and physical activity. Multivariable analysis was used to evaluate the independent effects of these factors and changes in BMI on late recurrence, GRC, and longterm survival.
Results:
Late recurrence or GRC occurred among 628 patients (8.1%). Older age (≥60 years) and total gastrectomy were identified as risk factors. Although lifestyle behaviors and BMI changes did not directly affect recurrence, they significantly affected mortality. In the total gastrectomy group, current underweight status (hazard ratio [HR], 1.586) was associated with increased mortality. Among the partial gastrectomy group, continued smoking (HR, 1.366) and current underweight status (HR, 1.915) increased mortality risk. Conversely, regular physical activity (starting: HR, 0.674; continuing: HR, 0.699) and postoperative overweight or obesity (BMI >25 kg/m 2 ) (HR, 0.713) were associated with reduced mortality.Changes in alcohol consumption showed inconsistent effects between the partial and total gastrectomy groups.
Conclusions
The long-term survival of post-gastrectomy patients improved with smoking cessation, regular physical activity, and maintenance of body weight.
2.Conversion Therapy for Stage IV Gastric Cancer: Report From the Expert Consensus Meeting at KINGCA WEEK 2024
Tae-Han KIM ; Ichiro UYAMA ; Sun Young RHA ; Maria BENCIVENGA ; Jiyeong AN ; Lucjan WYRWICZ ; Dong-Hoe KOO ; Richard van HILLEGERSBERG ; Keun-Wook LEE ; Guoxin LI ; Takaki YOSHIKAWA ; Brian BADGWELL ; Sylvie LORENZEN ; In-Ho KIM ; In-Seob LEE ; Hye-Sook HAN ; Hur HOON
Journal of Gastric Cancer 2025;25(1):133-152
Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC).To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy.The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion herapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%).Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.
3.The Influence of Lifestyle Behaviors and Body Mass Index Changes on Long-term Outcomes After Gastric Cancer Surgery: A Population-Based Cohort Study
Ju-Hee LEE ; Jiyeong KIM ; Dong-Gyu LEE
Journal of Gastric Cancer 2025;25(2):356-369
Purpose:
The present study investigated the impact of lifestyle behaviors and body mass index (BMI) on late recurrence, gastric remnant cancer (GRC), and long-term survival after curative gastrectomy.
Materials and Methods:
This retrospective study utilized data from the Korean National Health Insurance claims database. Among 71,014 patients with gastric cancer who underwent curative gastrectomy between January 2009 and December 2012, 23,359 remained cancerfree for five years. Of these, 7,735 patients with health examination data within 2 years before surgery and 5 years after surgery were analyzed for lifestyle behaviors, including smoking, alcohol consumption, and physical activity. Multivariable analysis was used to evaluate the independent effects of these factors and changes in BMI on late recurrence, GRC, and longterm survival.
Results:
Late recurrence or GRC occurred among 628 patients (8.1%). Older age (≥60 years) and total gastrectomy were identified as risk factors. Although lifestyle behaviors and BMI changes did not directly affect recurrence, they significantly affected mortality. In the total gastrectomy group, current underweight status (hazard ratio [HR], 1.586) was associated with increased mortality. Among the partial gastrectomy group, continued smoking (HR, 1.366) and current underweight status (HR, 1.915) increased mortality risk. Conversely, regular physical activity (starting: HR, 0.674; continuing: HR, 0.699) and postoperative overweight or obesity (BMI >25 kg/m 2 ) (HR, 0.713) were associated with reduced mortality.Changes in alcohol consumption showed inconsistent effects between the partial and total gastrectomy groups.
Conclusions
The long-term survival of post-gastrectomy patients improved with smoking cessation, regular physical activity, and maintenance of body weight.
4.Conversion Therapy for Stage IV Gastric Cancer: Report From the Expert Consensus Meeting at KINGCA WEEK 2024
Tae-Han KIM ; Ichiro UYAMA ; Sun Young RHA ; Maria BENCIVENGA ; Jiyeong AN ; Lucjan WYRWICZ ; Dong-Hoe KOO ; Richard van HILLEGERSBERG ; Keun-Wook LEE ; Guoxin LI ; Takaki YOSHIKAWA ; Brian BADGWELL ; Sylvie LORENZEN ; In-Ho KIM ; In-Seob LEE ; Hye-Sook HAN ; Hur HOON
Journal of Gastric Cancer 2025;25(1):133-152
Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC).To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy.The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion herapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%).Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.
5.The Influence of Lifestyle Behaviors and Body Mass Index Changes on Long-term Outcomes After Gastric Cancer Surgery: A Population-Based Cohort Study
Ju-Hee LEE ; Jiyeong KIM ; Dong-Gyu LEE
Journal of Gastric Cancer 2025;25(2):356-369
Purpose:
The present study investigated the impact of lifestyle behaviors and body mass index (BMI) on late recurrence, gastric remnant cancer (GRC), and long-term survival after curative gastrectomy.
Materials and Methods:
This retrospective study utilized data from the Korean National Health Insurance claims database. Among 71,014 patients with gastric cancer who underwent curative gastrectomy between January 2009 and December 2012, 23,359 remained cancerfree for five years. Of these, 7,735 patients with health examination data within 2 years before surgery and 5 years after surgery were analyzed for lifestyle behaviors, including smoking, alcohol consumption, and physical activity. Multivariable analysis was used to evaluate the independent effects of these factors and changes in BMI on late recurrence, GRC, and longterm survival.
Results:
Late recurrence or GRC occurred among 628 patients (8.1%). Older age (≥60 years) and total gastrectomy were identified as risk factors. Although lifestyle behaviors and BMI changes did not directly affect recurrence, they significantly affected mortality. In the total gastrectomy group, current underweight status (hazard ratio [HR], 1.586) was associated with increased mortality. Among the partial gastrectomy group, continued smoking (HR, 1.366) and current underweight status (HR, 1.915) increased mortality risk. Conversely, regular physical activity (starting: HR, 0.674; continuing: HR, 0.699) and postoperative overweight or obesity (BMI >25 kg/m 2 ) (HR, 0.713) were associated with reduced mortality.Changes in alcohol consumption showed inconsistent effects between the partial and total gastrectomy groups.
Conclusions
The long-term survival of post-gastrectomy patients improved with smoking cessation, regular physical activity, and maintenance of body weight.
6.Conversion Therapy for Stage IV Gastric Cancer: Report From the Expert Consensus Meeting at KINGCA WEEK 2024
Tae-Han KIM ; Ichiro UYAMA ; Sun Young RHA ; Maria BENCIVENGA ; Jiyeong AN ; Lucjan WYRWICZ ; Dong-Hoe KOO ; Richard van HILLEGERSBERG ; Keun-Wook LEE ; Guoxin LI ; Takaki YOSHIKAWA ; Brian BADGWELL ; Sylvie LORENZEN ; In-Ho KIM ; In-Seob LEE ; Hye-Sook HAN ; Hur HOON
Journal of Gastric Cancer 2025;25(1):133-152
Conversion therapy is a treatment strategy that shifts from palliative systemic therapy to curative surgical treatment for primary and/or metastatic stage IV gastric cancer (GC).To address its clinical statements, the Korean Gastric Cancer Association aims to present a consensus on conversion therapy among experts attending KINGCA WEEK 2024. The KINGCA Scientific Committee and Development Working Group for Korean Practice Guidelines prepared preformulated topics and 9 clinical statements for conversion therapy.The Delphi method was applied to a panel of 17 experts for consensus and opinions. The final comments were announced after the statement presentation and discussed during the consensus meeting session of KINGCA WEEK 2024. Most experts agreed that conversion herapy provides a survival benefit for selected patients who respond to systemic therapy and undergo R0 resection (88.3%). Patients with limited metastases were considered good candidates (94.2%). The optimal timing was based on the response to systemic therapy (70.6%). The regimen was recommended to be individualized (100%) and the duration to be at least 6 months (88.3%). A minimally invasive approach (82.3%) and D2 lymph node dissection (82.4%) were considered for surgery. However, resection for metastases with a complete clinical response after systemic therapy was not advocated (41.2%). All experts agreed on the need for large-scale randomized-controlled trials for further evidence (100%).Recent advancements in treatment may facilitate radical surgery for patients with stage IV GC. Further evidence is warranted to establish the safety and efficacy of conversion therapy.
7.The Number of Practicing Nurses Required to Resolve Differences in Staffing Levels between Capital and Non-capital Regions and the Relationship of Regional Differences in Staffing and Salary
Sung-Hyun CHO ; Ji-Yun LEE ; Jinhyun KIM ; U Ri GO ; Jiyeong SEONG
Journal of Korean Academy of Nursing Administration 2024;30(2):175-187
Purpose:
To estimate the number of practicing nurses required to resolve staffing differences between capital and non-capital regions and analyze the relationship between regional differences in staffing and salary.
Methods:
Using public data on population, patients, newly licensed nurses, practicing nurses, and annual salaries, regional differences were analyzed in newly licensed nurses per population, practicing nurses per population, practicing nurses per patient (i.e., staffing level), and salary. The number of additionally required practicing nurses was estimated by multiplying staffing differences by the number of patients in the lower-staffed region.
Results:
During 2002~2022, 71,107 and 243,611 newly licensed nurses were supplied, while the number of practicing nurses increased by 91,886 and 88,070 in the capital and non-capital regions, respectively. The non-capital region had more practicing nurses per population, whereas the capital region had more practicing nurses per patient. In 2020, 31,330 practicing nurses were additionally required in the non-capital region. Salaries were higher in the capital region, and regional salary differences increased during 2011~2020. Regional salary differences were associated with regional staffing differences and the number of additionally required practicing nurses.
Conclusion
Government and health insurance policies are required to encourage hospitals in the non-capital region to improve staffing and salaries.
8.The Number of Practicing Nurses Required to Resolve Differences in Staffing Levels between Capital and Non-capital Regions and the Relationship of Regional Differences in Staffing and Salary
Sung-Hyun CHO ; Ji-Yun LEE ; Jinhyun KIM ; U Ri GO ; Jiyeong SEONG
Journal of Korean Academy of Nursing Administration 2024;30(2):175-187
Purpose:
To estimate the number of practicing nurses required to resolve staffing differences between capital and non-capital regions and analyze the relationship between regional differences in staffing and salary.
Methods:
Using public data on population, patients, newly licensed nurses, practicing nurses, and annual salaries, regional differences were analyzed in newly licensed nurses per population, practicing nurses per population, practicing nurses per patient (i.e., staffing level), and salary. The number of additionally required practicing nurses was estimated by multiplying staffing differences by the number of patients in the lower-staffed region.
Results:
During 2002~2022, 71,107 and 243,611 newly licensed nurses were supplied, while the number of practicing nurses increased by 91,886 and 88,070 in the capital and non-capital regions, respectively. The non-capital region had more practicing nurses per population, whereas the capital region had more practicing nurses per patient. In 2020, 31,330 practicing nurses were additionally required in the non-capital region. Salaries were higher in the capital region, and regional salary differences increased during 2011~2020. Regional salary differences were associated with regional staffing differences and the number of additionally required practicing nurses.
Conclusion
Government and health insurance policies are required to encourage hospitals in the non-capital region to improve staffing and salaries.
9.The Number of Practicing Nurses Required to Resolve Differences in Staffing Levels between Capital and Non-capital Regions and the Relationship of Regional Differences in Staffing and Salary
Sung-Hyun CHO ; Ji-Yun LEE ; Jinhyun KIM ; U Ri GO ; Jiyeong SEONG
Journal of Korean Academy of Nursing Administration 2024;30(2):175-187
Purpose:
To estimate the number of practicing nurses required to resolve staffing differences between capital and non-capital regions and analyze the relationship between regional differences in staffing and salary.
Methods:
Using public data on population, patients, newly licensed nurses, practicing nurses, and annual salaries, regional differences were analyzed in newly licensed nurses per population, practicing nurses per population, practicing nurses per patient (i.e., staffing level), and salary. The number of additionally required practicing nurses was estimated by multiplying staffing differences by the number of patients in the lower-staffed region.
Results:
During 2002~2022, 71,107 and 243,611 newly licensed nurses were supplied, while the number of practicing nurses increased by 91,886 and 88,070 in the capital and non-capital regions, respectively. The non-capital region had more practicing nurses per population, whereas the capital region had more practicing nurses per patient. In 2020, 31,330 practicing nurses were additionally required in the non-capital region. Salaries were higher in the capital region, and regional salary differences increased during 2011~2020. Regional salary differences were associated with regional staffing differences and the number of additionally required practicing nurses.
Conclusion
Government and health insurance policies are required to encourage hospitals in the non-capital region to improve staffing and salaries.
10.The Number of Practicing Nurses Required to Resolve Differences in Staffing Levels between Capital and Non-capital Regions and the Relationship of Regional Differences in Staffing and Salary
Sung-Hyun CHO ; Ji-Yun LEE ; Jinhyun KIM ; U Ri GO ; Jiyeong SEONG
Journal of Korean Academy of Nursing Administration 2024;30(2):175-187
Purpose:
To estimate the number of practicing nurses required to resolve staffing differences between capital and non-capital regions and analyze the relationship between regional differences in staffing and salary.
Methods:
Using public data on population, patients, newly licensed nurses, practicing nurses, and annual salaries, regional differences were analyzed in newly licensed nurses per population, practicing nurses per population, practicing nurses per patient (i.e., staffing level), and salary. The number of additionally required practicing nurses was estimated by multiplying staffing differences by the number of patients in the lower-staffed region.
Results:
During 2002~2022, 71,107 and 243,611 newly licensed nurses were supplied, while the number of practicing nurses increased by 91,886 and 88,070 in the capital and non-capital regions, respectively. The non-capital region had more practicing nurses per population, whereas the capital region had more practicing nurses per patient. In 2020, 31,330 practicing nurses were additionally required in the non-capital region. Salaries were higher in the capital region, and regional salary differences increased during 2011~2020. Regional salary differences were associated with regional staffing differences and the number of additionally required practicing nurses.
Conclusion
Government and health insurance policies are required to encourage hospitals in the non-capital region to improve staffing and salaries.

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