Juez Luz Divina, Priego Pablo, Cuadrado Marta, Blázquez Luis A, Sánchez-Picot Silvia, Gil Pablo, Longo Federico, Galindo Julio, Fernández-Cebrián José María, Botella-Carretero José I
Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Instituto Ramón y Cajal de Investigación Sanitaria, IRyCIS, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Cancers (Basel). 2024 Jun 29;16(13):2408. doi: 10.3390/cancers16132408.
Neoadjuvant chemotherapy (NT) followed by radical surgery is the standard treatment for locally advanced gastric cancer (GC). The incidence of sarcopenia in upper gastrointestinal tract malignancies is very high, and it may be increased after NT. This study aimed to evaluate the impact of NT on body composition. A retrospective study of patients with locally advanced GC undergoing gastrectomy who had received NT in a tertiary hospital between 2012 and 2019 was conducted. CT measured the skeletal muscle index, total psoas area, and visceral and subcutaneous adipose tissue before and after NT. Of the 180 gastrectomies for GC, 61 patients received NT. During NT, changes in body composition were observed with a decrease in the skeletal muscle mass index (SMMI -2.5%; < 0.001), and these changes were significantly greater in men (SMMI -10.55%). Before surgery, patients who received NT presented 15% more sarcopenia than those without NT ( = 0.048). In conclusion, patients with locally advanced gastric cancer who receive NT have significant changes in body composition during chemotherapy. These changes, which are at the expense of a loss of muscle mass, lead to an increased incidence of pre-surgical sarcopenia.
新辅助化疗（NT）后行根治性手术是局部晚期胃癌（GC）的标准治疗方法。上消化道恶性肿瘤患者中肌肉减少症的发生率非常高，NT治疗后该发生率可能会增加。本研究旨在评估NT对身体成分的影响。对2012年至2019年期间在一家三级医院接受NT治疗并行胃切除术的局部晚期GC患者进行了一项回顾性研究。通过CT测量NT前后的骨骼肌指数、腰大肌总面积以及内脏和皮下脂肪组织。在180例GC胃切除术中，61例患者接受了NT治疗。在NT治疗期间，观察到身体成分发生变化，骨骼肌质量指数下降（SMMI -2.5%；<0.001），男性的这些变化更为显著（SMMI -10.55%）。术前，接受NT治疗的患者肌肉减少症发生率比未接受NT治疗的患者高15%（=0.048）。总之，接受NT治疗的局部晚期胃癌患者在化疗期间身体成分发生显著变化。这些变化以肌肉量减少为代价，导致术前肌肉减少症发生率增加。
