Division of Colorectal and Anal Surgery, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, The People's Republic of China.
Guangxi Clinical Research Center for Colorectal Cancer, Nanning, The People's Republic of China.
Cancer Control. 2023 Jan-Dec;30:10732748231164016. doi: 10.1177/10732748231164016.
The aim of the current study was to identify the relationship between body composition changes during neoadjuvant therapy (NAT) and the treatment efficiency of NAT in gastrointestinal cancer (GC) patients.
From January 2015 to July 2020, 277 GC patients treated with NAT had included for retrospective analysis. The body mass index (BMI) and computed tomography (CT) imaging before and after NAT were recorded. The BMI change optimal cut-off value were calculated by ROC curve. Balancing essential characteristic variables using propensity score matching (PSM) method. Exploring the association between BMI changes and tumor response to NAT using logistic regression analysis. The survival outcome of matched patients between different BMI change groups was compared.
A cutoff point of BMI change >2% during NAT was defined as BMI loss. Among the 277 patients, 110 (39.7%) patients showed BMI change with a loss after NAT. In total, 71 pairs of patients were selected for further analysis. The median follow-up time was 22 months (range 3 to 63 months). Univariate and multivariate logistic regression analyses in matched cohort showed that BMI change was a prognostic factor for tumor response after NAT in GC patients (odds ratio (OR), .471; 95% confidence interval (CI), .233-.953; = .036). In addition, patients who experienced BMI loss after NAT showed worse overall survival than those who had BMI gain or stable.
BMI loss during NAT probably may has negative effects on NAT efficiency and survival for gastrointestinal cancer patients. It is necessary to monitor and maintain weight for patients during treatment.
本研究旨在确定新辅助治疗（NAT）期间的身体成分变化与胃肠道癌（GC）患者 NAT 治疗效果之间的关系。
回顾性分析 2015 年 1 月至 2020 年 7 月期间接受 NAT 治疗的 277 例 GC 患者。记录 NAT 前后的体重指数（BMI）和计算机断层扫描（CT）成像。通过 ROC 曲线计算 BMI 变化的最佳截断值。使用倾向评分匹配（PSM）方法平衡基本特征变量。使用逻辑回归分析探索 BMI 变化与 NAT 肿瘤反应之间的关系。比较不同 BMI 变化组匹配患者的生存结局。
定义 NAT 期间 BMI 变化>2%为 BMI 下降。在 277 例患者中，有 110（39.7%）例患者 NAT 后 BMI 下降。共有 71 对患者被选入进一步分析。中位随访时间为 22 个月（范围 3 至 63 个月）。匹配队列的单因素和多因素逻辑回归分析表明，BMI 变化是 GC 患者 NAT 后肿瘤反应的预后因素（比值比（OR），0.471；95%置信区间（CI），0.233-0.953；=0.036）。此外，与 BMI 增加或稳定的患者相比，NAT 后 BMI 下降的患者总生存较差。
NAT 期间 BMI 下降可能对 NAT 效率和胃肠道癌患者的生存产生负面影响。在治疗期间有必要监测和维持患者的体重。
