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计算机断层扫描测量的身体成分:与食管癌患者术后发病率和死亡率的相关性

Computed tomography-measured body composition: correlation with postoperative morbidity and mortality in patients with gastroesophageal cancer.

作者信息

Bitencourt Almir Galvão Vieira, Miola Thais Manfrinato, Souza Juliana de Oliveira, da Conceição Elizabeth Launeir Santos, Coimbra Felipe José Fernandez, Barbosa Paula Nicole Vieira Pinto

机构信息

A.C.Camargo Cancer Center, São Paulo, SP, Brazil.

Universidade Nove de Julho, São Paulo, SP, Brazil.

出版信息

Radiol Bras. 2019 Nov-Dec;52(6):351-355. doi: 10.1590/0100-3984.2019.0009.

Abstract

OBJECTIVE

To determine whether preoperative anthropometric and computed tomography (CT) measurements of body composition can predict postoperative morbidity and mortality in patients with gastric or esophageal cancer.

MATERIALS AND METHODS

This was a retrospective study in which we reviewed the medical records and abdominal CT scans of patients with gastric or esophageal cancer who underwent surgery in 2015 at a cancer center. CT scans performed during routine preoperative evaluation were retrospectively assessed to measure the area of lean body mass at the level of the third lumbar vertebra, as well as the area of visceral and subcutaneous fat.

RESULTS

Seventy patients were included in the study. The mean age was 59.9 years (range, 33-82 years), and 47 patients (67.1%) were men. The mean postoperative follow-up period was 14.9 months. Neither postoperative morbidity nor postoperative mortality correlated significantly with gender, age, the type of primary tumor, the presence of comorbidities, smoking status, body mass index, nutritional status, or visceral fat area. The survival rate was higher for patients with normal lean body mass than for those with low lean body mass (hazard ratio = 0.116; 95% confidence interval: 0.015-0.906; = 0.040).

CONCLUSION

Our data suggest that lean body mass can be a relevant prognostic factor in patients with gastric or esophageal cancer, and that CT measurements should be included in the routine preoperative evaluation, because it may provide information that aids nutritional and clinical care for these patients.

摘要

目的

确定术前人体测量学指标和计算机断层扫描(CT)测量的身体成分能否预测胃癌或食管癌患者术后的发病率和死亡率。

材料与方法

这是一项回顾性研究,我们查阅了2015年在一家癌症中心接受手术的胃癌或食管癌患者的病历和腹部CT扫描结果。对术前常规评估期间进行的CT扫描进行回顾性分析,以测量第三腰椎水平的瘦体重面积以及内脏脂肪和皮下脂肪面积。

结果

70例患者纳入研究。平均年龄为59.9岁(范围33 - 82岁),47例(67.1%)为男性。术后平均随访时间为14.9个月。术后发病率和死亡率均与性别、年龄、原发肿瘤类型、合并症的存在、吸烟状况、体重指数、营养状况或内脏脂肪面积无显著相关性。瘦体重正常的患者生存率高于瘦体重低的患者(风险比 = 0.116;95%置信区间:0.015 - 0.906;P = 0.040)。

结论

我们的数据表明,瘦体重可能是胃癌或食管癌患者的一个相关预后因素,并且CT测量应纳入术前常规评估,因为它可能提供有助于这些患者营养和临床护理的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b02/7007052/40fbf00d9b10/rb-52-06-0356-g01.jpg

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