Department of Gastrointestinal and Hepato-biliary-pancreatic Surgery, Nippon Medical School, Tokyo, Japan
Department of Gastrointestinal and Hepato-biliary-pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
Anticancer Res. 2020 Aug;40(8):4271-4279. doi: 10.21873/anticanres.14429.
BACKGROUND/AIM: Skeletal muscle mass (SMM) is often depleted in patients with gastric cancer undergoing gastrectomy. Using a novel method, we evaluated the effect of SMM depletion after gastrectomy on disease prognosis.
The maximum cross-sectional area of the psoas-muscle (MCA-PM) was measured before surgery and at 1 year after in 233 patients with gastric cancer who underwent radical gastrectomy to determine the ratio (MCA-PMR) as an indicator of SMM depletion.
The MCA-PMR cutoff value was set at 90%, and patients were divided into the groups with <90% and ≥90%. MCA-PMR <90% was an independent prognostic factor for all patients. In 88 patients who received adjuvant chemotherapy including S-1, the 5-year cancer-specific survival rate was significantly better for those with MCA-PMR ≥90% than for those with MCA-PMR <90% (84.1% vs. 59.1%; p=0.010; hazard ratio=2.974; 95% confidence interval=1.241-7.124).
SMM depletion after gastrectomy can be measured using the MCA-PMR. This novel measurement can be easily implemented in the clinical setting.
背景/目的：胃癌患者在行胃切除术后常伴有骨骼肌量（SMM）耗竭。我们采用一种新方法评估胃切除术后 SMM 耗竭对疾病预后的影响。
对 233 例行根治性胃切除术的胃癌患者，在术前和术后 1 年测量竖脊肌最大横截面积（MCA-PM），以确定 SMM 耗竭的指标（MCA-PMR）。
MCA-PMR 截断值设定为 90%，将患者分为 MCA-PMR<90%和≥90%两组。MCA-PMR<90%是所有患者的独立预后因素。在 88 例接受包括 S-1 在内的辅助化疗的患者中，MCA-PMR≥90%的患者 5 年癌症特异性生存率明显优于 MCA-PMR<90%的患者（84.1% vs. 59.1%；p=0.010；风险比=2.974；95%置信区间=1.241-7.124）。
胃切除术后 SMM 耗竭可以用 MCA-PMR 来衡量。这种新的测量方法可以很容易地在临床环境中实施。
