Zuo Lugen, Lin Jianxiu, Ge Sitang, Wu Rong, Liu Baoxinzi, Cheng Ying, Tian Yun
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China.
First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P.R. China.
Oncol Lett. 2024 Jan 15;27(3):99. doi: 10.3892/ol.2024.14233. eCollection 2024 Mar.
Visceral adipose tissue and skeletal muscle mass are associated with carcinogenesis and clinical outcomes in patients with cancer. The aim of the present study was to determine the influence of body composition parameters on postoperative survival in patients with gastric cancer. Demographic data and systemic inflammatory response data were obtained from patients with gastric cancer undergoing radical gastrectomy. The patient's skeletal muscle and visceral fat were assessed using computed tomography, and the corresponding skeletal muscle index (SMI) and visceral fat index (VFI) were calculated. Univariate and multivariate analyses were then performed. Of the 342 patients from whom information was collected, 125 of these patients eventually succumbed to the disease. A total of 271 (79.24%) of the patients were male and 71 (20.76%) were female. Regarding the entire cohort, the mean age was 64 years [interquartile range (IQR), 56-74 years], while the mean body mass index collected was 21.53 (IQR, 19.27-24.22). The median SMI and VFI of the patients were 47.73 (IQR, 41.67-55.51) and 41.28 (IQR, 36.62-45.36), respectively. It was concluded that a low SMI and VFI were associated with worse survival outcomes. However, the neutrophil-to-lymphocyte ratio and perioperative blood transfusion were not significantly associated with overall survival (OS). Among the indicators assessed, a low VFI was an independent risk factor associated with the worst OS time (hazard ratio 1.59; confidence interval, 1.03-2.45; P=0.038). Finally, a prognostic nomogram was constructed which included the VFI to assist clinicians in making more informed decisions. In conclusion, after data collection and analysis, it was found that there was a significant correlation between a low VFI and a shorter OS time in patients with gastric cancer following gastrectomy, suggesting that VFI may be a promising therapeutic target for postoperative interventions to improve patient survival further.
内脏脂肪组织和骨骼肌质量与癌症患者的致癌作用及临床结局相关。本研究的目的是确定身体成分参数对胃癌患者术后生存的影响。从接受根治性胃切除术的胃癌患者中获取人口统计学数据和全身炎症反应数据。使用计算机断层扫描评估患者的骨骼肌和内脏脂肪,并计算相应的骨骼肌指数(SMI)和内脏脂肪指数(VFI)。然后进行单因素和多因素分析。在收集到信息的342例患者中,有125例最终死于该疾病。共有271例(79.24%)患者为男性,71例(20.76%)为女性。就整个队列而言,平均年龄为64岁[四分位间距(IQR),56 - 74岁],而收集到的平均体重指数为21.53(IQR,19.27 - 24.22)。患者的SMI中位数和VFI分别为47.73(IQR,41.67 - 55.51)和41.28(IQR,36.62 - 45.36)。得出的结论是,低SMI和VFI与较差的生存结局相关。然而,中性粒细胞与淋巴细胞比值和围手术期输血与总生存期(OS)无显著相关性。在评估的指标中,低VFI是与最差OS时间相关的独立危险因素(风险比1.59;置信区间,1.03 - 2.45;P = 0.038)。最后,构建了一个包含VFI的预后列线图,以帮助临床医生做出更明智的决策。总之,经过数据收集和分析,发现胃癌患者胃切除术后低VFI与较短的OS时间之间存在显著相关性,这表明VFI可能是进一步改善患者生存的术后干预的有前景的治疗靶点。