Research Institute of General Surgery, Jinling Hospital, The first School of Clinical Medicine, Southern Medical University, Nanjing, China.
Department of Cardiothoracic Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
J Invest Surg. 2021 Aug;34(8):875-882. doi: 10.1080/08941939.2019.1708997. Epub 2020 Jan 29.
The purpose of this study was to assess the body composition score (BCS) impact on 3-year survival after radical gastrectomy in patients with gastric cancer.
This retrospective study included patients with gastric cancer from September 2015 to June 2017. The patients were divided into three groups: BCS0 (having normal skeletal muscle or adipose mass), BCS1 (having low skeletal muscle mass only), and BCS2 (having low skeletal muscle and adipose mass) according to their third lumbar vertebra skeletal muscle index and fat index calculated using abdominal computed tomography. The clinicopathological indicators, postoperative complications, 3-year over survival (OS) rate after radical gastrectomy, and cause of death among the three groups were compared.
A total of 187 patients were enrolled in the study, in which 102 patients (54.6%) had BCS0, 76 (40.6%) had BCS1 and 9 (4.8%) had BCS2. There was no significant difference in postoperative complications among the groups. 3-year OS was significantly shortened with each 1-score increase in BCS (Log-rank 0.001). Multivariate Cox regression analyses showed that no neoadjuvant chemotherapy, tumor stage III, BCS1, and BCS2 were independent prognostic factors for 3-year OS after radical gastrectomy. The main cause of death was cancer-related.
We demonstrated that BCS1 and BCS2 were strongly associated with poor 3-year survival for patients with gastric cancer who underwent radical gastrectomy, suggesting that special attention may be required for nutritional support while determining therapeutic strategies.
本研究旨在评估胃癌根治术后体成分评分（BCS）对 3 年生存的影响。
本回顾性研究纳入 2015 年 9 月至 2017 年 6 月期间的胃癌患者。根据腹部 CT 计算的第三腰椎骨骼肌指数和脂肪指数，将患者分为三组：BCS0（骨骼肌或脂肪质量正常）、BCS1（仅骨骼肌质量低）和 BCS2（骨骼肌和脂肪质量均低）。比较三组患者的临床病理指标、术后并发症、根治性胃切除术后 3 年总生存率（OS）及死亡原因。
共纳入 187 例患者，其中 102 例（54.6%）为 BCS0，76 例（40.6%）为 BCS1，9 例（4.8%）为 BCS2。三组患者术后并发症无显著差异。BCS 每增加 1 分，3 年 OS 明显缩短（Log-rank 0.001）。多因素 Cox 回归分析显示，无新辅助化疗、肿瘤分期 III 期、BCS1 和 BCS2 是根治性胃切除术后 3 年 OS 的独立预后因素。死亡的主要原因是癌症相关。
本研究表明，BCS1 和 BCS2 与接受根治性胃切除术的胃癌患者 3 年生存不良密切相关，提示在确定治疗策略时可能需要特别注意营养支持。
