Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Surg Today. 2020 Mar;50(3):217-222. doi: 10.1007/s00595-019-01815-8. Epub 2019 Apr 26.
Surgical resection and perioperative adjuvant therapy are widely accepted standard treatments for gastrointestinal cancer. However, body composition changes, such as weight loss and skeletal muscle loss, are unavoidable during these treatments. Several studies have shown that perioperative body composition changes are affected by multimodal treatment for gastrointestinal cancer. This review summarizes the background, current status, and future perspectives of perioperative body composition changes in the multimodal treatment of gastrointestinal cancer. Recent studies have described the body composition changes observed in the early period after surgery and during adjuvant therapy. Changes in the body composition might affect adjuvant chemotherapy toxicity after surgery and postoperative complications after neoadjuvant therapy. The mechanisms underlying body composition changes during multimodal therapy are multifactorial and include systemic inflammation, reduced nutrient intake, and physical inactivity. Several approaches have been tested to maintain the body composition, and especially prevent skeletal muscle wasting, during multimodal therapy. Although the ideal approach for managing body composition changes in gastrointestinal cancer patients remains unclear, recent studies support the combination of multiple approaches rather than a single approach.
手术切除和围手术期辅助治疗是广泛接受的胃肠道癌症标准治疗方法。然而，在这些治疗过程中，体重减轻和骨骼肌减少等身体成分变化是不可避免的。几项研究表明，围手术期身体成分变化受胃肠道癌症的多模式治疗影响。这篇综述总结了胃肠道癌症多模式治疗中围手术期身体成分变化的背景、现状和未来展望。最近的研究描述了手术后早期和辅助治疗期间观察到的身体成分变化。身体成分的变化可能会影响手术后辅助化疗的毒性和新辅助治疗后的术后并发症。多模式治疗期间身体成分变化的机制是多因素的，包括全身炎症、营养摄入减少和身体活动减少。已经测试了几种方法来维持多模式治疗期间的身体成分，特别是预防骨骼肌减少。虽然胃肠道癌症患者管理身体成分变化的理想方法仍不清楚，但最近的研究支持多种方法的联合应用，而不是单一方法。
