Computed tomography–quantified body composition predicts short-term outcomes after gastrectomy in gastric cancer

Current oncology

X. L. Wang¹  F. Tian²  L. M. Tang³  T. T. Gao⁴  J. W. Wang⁵  J. P. Wang⁶  H. Tian⁷  Y. Zhang⁸ 

[1] Jinling Hospital, Medical School of Nanjing University;School of Clinical Medicine of Nanjing Medical University;The Affiliated Hospital of Nanjing Medical University;Changzhou No. 2 People’s Hospital;Intensive Care Unit, Sir Run Run Shaw Hospital, Medical School of Zhejiang University;Jinling Clinical Medical College of Nanjing Medical University;Jinling Hospital Affiliated to Southern Medical University;Jinling Hospital, Medical School of Nanjing University

关键词: Body composition;    sarcopenia;    myosteatosis;    visceral obesity;    gastrectomy;    complications;   

DOI  :  10.3747/co.25.4014

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

BackgroundMalnutrition is a common and critical problem that influences outcome in cancer patients. Body composition reflects a patient’s metabolic profile and physiologic reserves, which might be the true determinant of prognosis. In the present study, which aimed to identify valuable new prognostic indicators, we investigated the association between computed tomography–quantified body composition and short-term outcomes after gastrectomy for gastric cancer. Methods Skeletal muscle index, mean muscle attenuation, and ratio of visceral-to-subcutaneous adipose tissue area (vsr) were calculated from preoperative computed tomography images. Low skeletal muscle index, low mean muscle attenuation, and high vsr were respectively termed “sarcopenia,” “myosteatosis,” and “visceral obesity.” The association of body composition with postoperative complications and serum markers of nutrition and inflammation after radical gastrectomy were analyzed. Results The overall complication rate was significantly higher in the sarcopenia (62.5% vs. 27.3%,p= 0.001) and myosteatosis groups (38.2% vs. 4%,p= 0.002). Patients with visceral obesity had a higher incidence of inflammatory complications (20.3% vs. 6.5%,p= 0.01). Multivariate logistic regression analysis demonstrated that sarcopenia ( p= 0.013), myosteatosis ( p= 0.017), and low serum retinol-binding protein ( p= 0.019) were independent risk factors for overall complications. Compared with control subjects, patients with sarcopenia had lower postoperative levels of serum retinol-binding protein ( p= 0.007), and patients with visceral obesity had higher levels of C-reactive protein ( p= 0.026). ConclusionsSarcopenia, myosteatosis, and visceral obesity were significantly associated with increased rates of postoperative complications and affected the postoperative nutrition and inflammation status of patients with gastric cancer.

【 授权许可】

Unknown