Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Anticancer Res. 2024 Sep;44(9):4031-4037. doi: 10.21873/anticanres.17232.
BACKGROUND/AIM: The purpose of the present study was to assess the clinical impact of body weight loss (BWL) during chemotherapy in patients with initially unresectable advanced gastric cancer who underwent conversion surgery.
This retrospective study included 61 patients with stage IV gastric cancer who underwent conversion surgery after chemotherapy, and body weight changes during chemotherapy were examined. Based on receiver operating characteristic (ROC) curve analysis of body weight change for disease recurrence, the cutoff value of BWL was determined. Based on the BWL cutoff value, patients were classified into two groups.
Body weight change ranged from 28.2% to -21.8%. The cut-off value of BWL was set at 6% based on the ROC analysis. Of the 61 patients, 45 (74%) and 16 (26%) had <6% and ≥6% BWL, respectively. Patients with ≥6% BWL had peritoneal dissemination, pathological lymph node metastasis, residual tumor status of R1-2, and disease recurrence compared with those with <6% BWL (all p<0.05). The median survival times after conversion surgery were 21 and 63 months in the ≥6% and <6% BWL groups, respectively (p<0.01). Univariate analysis identified BWL as an independent prognostic factor (p=0.01), although histological response alone was significantly associated with survival in the multivariate analysis (p=0.02).
Patients with severe BWL during chemotherapy may be excluded from the indication of conversion surgery.
背景/目的：本研究旨在评估初始不可切除的晚期胃癌患者在接受转化手术后化疗期间体重减轻（BWL）对临床的影响。
本回顾性研究纳入了 61 例接受化疗后行转化手术的 IV 期胃癌患者，并检查了化疗期间的体重变化。基于体重变化对疾病复发的Receiver Operating Characteristic（ROC）曲线分析，确定了 BWL 的截断值。根据 BWL 截断值，将患者分为两组。
体重变化范围为 28.2%至-21.8%。基于 ROC 分析，BWL 的截断值设定为 6%。在 61 例患者中，45 例（74%）和 16 例（26%）的 BWL<6%和≥6%。与 BWL<6%的患者相比，BWL≥6%的患者具有腹膜扩散、病理淋巴结转移、R1-2 残留肿瘤状态和疾病复发（均 p<0.05）。转化手术后的中位生存时间分别为 BWL≥6%组和 BWL<6%组的 21 个月和 63 个月（p<0.01）。单因素分析发现 BWL 是独立的预后因素（p=0.01），尽管组织学反应在多因素分析中与生存显著相关（p=0.02）。
化疗期间体重严重减轻的患者可能不符合转化手术的适应证。
