Hirase Yuki, Arigami Takaaki, Matsushita Daisuke, Shimonosono Masataka, Tsuruda Yusuke, Sasaki Ken, Baba Kenji, Kawasaki Yota, Ohtsuka Takao
Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Langenbecks Arch Surg. 2024 Dec 14;410(1):7. doi: 10.1007/s00423-024-03574-8.
Recently, several investigators have focused on the clinical significance of osteosarcopenia in malignancies; however, its prognostic impact on patients with gastric cancer after conversion surgery (CS) remains unclear. Therefore, we aimed to investigate sarcopenia, osteopenia, and osteosarcopenia in this patient population.
We retrospectively analyzed 24 patients with gastric cancer who underwent CS. Before CS, the skeletal muscle index at the L3 vertebra and bone mineral density at the Th11 vertebra were measured to investigate sarcopenia and osteopenia, respectively. Osteosarcopenia was defined as the coexistence of sarcopenia and osteopenia. The relationship between perioperative osteosarcopenia and patient prognosis, including clinicopathological factors, was assessed.
Among the 24 patients, 10 (42%) had osteosarcopenia. Osteosarcopenia was significantly correlated with body mass index, depth of tumor invasion, and tumor stage (all p < 0.05). The median overall survival and disease-free survival after CS in patients with osteosarcopenia were significantly shorter than those in patients without osteosarcopenia (all p < 0.05). In the multivariate analysis, osteosarcopenia was identified as an independent factor related to overall survival alone (p = 0.04).
Assessment of osteosarcopenia has clinical utility in predicting the prognosis after CS in patients with stage IV gastric cancer after chemotherapy.
最近，一些研究人员关注了骨肉减少症在恶性肿瘤中的临床意义；然而，其对胃癌转化手术（CS）后患者的预后影响仍不清楚。因此，我们旨在研究该患者群体中的肌肉减少症、骨质减少症和骨肉减少症。
我们回顾性分析了24例行CS的胃癌患者。在CS前，分别测量L3椎体的骨骼肌指数和Th11椎体的骨密度，以研究肌肉减少症和骨质减少症。骨肉减少症定义为肌肉减少症和骨质减少症并存。评估围手术期骨肉减少症与患者预后（包括临床病理因素）之间的关系。
24例患者中，10例（42%）患有骨肉减少症。骨肉减少症与体重指数、肿瘤浸润深度和肿瘤分期显著相关（均p<0.05）。骨肉减少症患者CS后的中位总生存期和无病生存期显著短于无骨肉减少症的患者（均p<0.05）。在多变量分析中,骨肉减少症被确定为仅与总生存期相关的独立因素（p=0.04）。
评估骨肉减少症对预测化疗后IV期胃癌患者CS后的预后具有临床实用价值。
