Hirase Yuki, Arigami Takaaki, Matsushita Daisuke, Shimonosono Masataka, Uenosono Yoshikazu, Yanagita Shigehiro, 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.
Gastric Cancer. 2025 Apr 27. doi: 10.1007/s10120-025-01617-7.
Gastric cancer remains a significant global challenge, with conventional surgery for early gastric cancer often leading to post-gastrectomy complications. Sentinel node navigation surgery is being developed to preserve quality of life without compromising radicality. Although osteosarcopenia is linked to gastrointestinal cancers and prognosis, its impact on bone and muscle mass after function-preserving surgery for gastric cancer remains underexplored.
We analyzed the data of patients diagnosed with early gastric cancer and not eligible for endoscopic treatments, who underwent either distal gastrectomy or sentinel node navigation surgery at our hospital between 2010 and 2020. Skeletal muscle index and bone mineral density were measured preoperatively and 1, 3, and 5 years, postoperatively; rates of changes in these measures were assessed.
Among the 63 patients included, 42 (67%) underwent conventional surgery, and 21 (33%) underwent function-preserving gastrectomy using the sentinel node technique. No significant difference in postoperative survival rates was observed between the two groups (P = 0.97). The rate of change in the skeletal muscle index and bone mineral density decreased in both groups from 1 to 3 years postoperatively. At 5 years postoperatively, the sentinel node navigation surgery group showed an increase in skeletal muscle index and bone mineral density change rates, the difference observed between the two groups was significant (P < 0.05).
Sentinel node navigation surgery for early gastric cancer may help prevent decreases in bone and muscle mass. This suggests that its use has a potential role in preventing osteosarcopenia.
胃癌仍然是一项重大的全球挑战，早期胃癌的传统手术常常导致胃切除术后并发症。前哨淋巴结导航手术正在研发中，旨在在不影响根治性的情况下保留生活质量。尽管骨肌减少症与胃肠道癌症及预后相关，但其对胃癌功能保留手术后骨量和肌肉量的影响仍未得到充分研究。
我们分析了2010年至2020年间在我院被诊断为早期胃癌且不适合内镜治疗的患者的数据，这些患者接受了远端胃切除术或前哨淋巴结导航手术。术前及术后1年、3年和5年测量骨骼肌指数和骨密度；评估这些指标的变化率。
在纳入的63例患者中，42例（67%）接受了传统手术，21例（33%）采用前哨淋巴结技术进行了功能保留性胃切除术。两组术后生存率无显著差异（P = 0.97）。两组术后1至3年骨骼肌指数和骨密度的变化率均下降。术后5年，前哨淋巴结导航手术组的骨骼肌指数和骨密度变化率有所增加，两组间差异显著（P < 0.05）。
早期胃癌的前哨淋巴结导航手术可能有助于预防骨量和肌肉量的减少。这表明其应用在预防骨肌减少症方面具有潜在作用。
