COMMENTARY

An Easy Fix for Esophagectomy-Induced Weight Loss?

Albert B. Lowenfels, MD

Disclosures

August 20, 2010

Randomized Phase II Study of Clinical Effects of Ghrelin After Esophagectomy With Gastric Tube Reconstruction

Yamamoto K, Takiguchi S, Miyata H, et al
Surgery. 2010;148:31-38

Is there a way to prevent the marked weight loss that so frequently accompanies esophagectomy? Yamamoto and colleagues conducted a randomized trial comparing ghrelin, a peptide gut hormone secreted by the stomach, with placebo in 20 patients with esophageal cancer. Treated patients received intravenous ghrelin twice daily over 10 days. Ghrelin significantly increased food intake (P = .015) and diminished the amount of postoperative weight loss (P = .019) without any significant adverse effects.

Viewpoint

As the investigators point out, weight loss after surgery for esophageal cancer can be significant, causing depression of the immune system and leading to decreased survival. Short-term administration of ghrelin, a potent gut hormone, seems to be beneficial. Only short-term results are reported, so longer phase III follow-up studies are needed, with follow-up extending over months. Furthermore, we need additional evidence that this agent has a beneficial effect on patient survival.

Abstract

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