Huang Jing-Min, Yang Jin-Yu
School of Clinical Medicine, Qinghai University, Xining, China.
Department of General Surgery, Qinghai University Affiliated Hospital, Xining, China.
Surg Today. 2025 Jun 28. doi: 10.1007/s00595-025-03058-2.
To examine the prognostic utility of the albumin-myosteatosis gauge (AMG) in patients diagnosed with locally advanced gastric cancer (LAGC) who underwent neoadjuvant chemotherapy (NAC) followed by radical gastrectomy.
Data from 198 patients who underwent NAC and radical resection of LAGC at our center between January 2014 and December 2021 were analyzed. The AMG was calculated as the product of skeletal muscle radiodensity and albumin levels. Logistic and Cox regression models were used to determine the predictive utility of pre- and post-NAC AMG for the pathological response and survival.
A higher AMG, regardless of whether measured before or after NAC, was associated with better performance status and higher pathological response rates (P < 0.05). In the multivariate analysis, pre-NAC AMG, rather than post-NAC AMG, was an independent predictor of the pathological response (odds ratio 2.621 [95% confidence interval {CI} 1.376-4.993]; P = 0.003). This predictive value was consistent across subgroups. Furthermore, post-NAC AMG, rather than pre-NAC AMG, was an independent prognostic factor for the overall survival (hazard ratio 0.611 [95% CI, 0.375-0.997]; P = 0.049) and recurrence-free survival (hazard ratio 0.538 [95% CI 0.338-0.857]; P = 0.009). This prognostic utility was consistent across most subgroups, except for the obese subgroup.
AMG may be a useful tool for predicting the response to NAC in patients diagnosed with LAGC.
探讨白蛋白-肌脂变指数（AMG）对接受新辅助化疗（NAC）后行根治性胃切除术的局部进展期胃癌（LAGC）患者的预后评估价值。
分析2014年1月至2021年12月期间在本中心接受NAC及LAGC根治性切除术的198例患者的数据。AMG计算为骨骼肌放射密度与白蛋白水平的乘积。采用逻辑回归和Cox回归模型确定NAC前后AMG对病理反应和生存的预测价值。
无论NAC前还是NAC后测量，较高的AMG与较好的体能状态和较高的病理反应率相关（P＜0.05）。在多变量分析中，NAC前AMG而非NAC后AMG是病理反应的独立预测因素（优势比2.621[95%置信区间{CI}1.376 - 4.993]；P = 0.003）。这一预测价值在各亚组中一致。此外，NAC后AMG而非NAC前AMG是总生存（风险比0.611[95% CI，0.375 - 0.997]；P = 0.049）和无复发生存（风险比0.538[95% CI 0.338 - 0.857]；P = 0.009）的独立预后因素。除肥胖亚组外，这一预后价值在大多数亚组中一致。
AMG可能是预测LAGC患者对NAC反应的有用工具。
