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Marked Loss of Muscle, Visceral Fat, or Subcutaneous Fat After Gastrectomy Predicts Poor Survival in Advanced Gastric Cancer: Single-Center Study from the CLASSIC Trial

Authors
 Hyung Soon Park  ;  Hyo Song Kim  ;  Seung Hoon Beom  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Jee Hung Kim  ;  You Jin Chun  ;  Si Won Lee  ;  Eun-Ah Choe  ;  Su Jin Heo  ;  Sung Hoon Noh  ;  Woo Jin Hyung  ;  Jae-Ho Cheong  ;  Hyoung-Il Kim  ;  Taeil Son  ;  Joon Seok Lim  ;  Song-Ee Baek  ;  Minkyu Jung 
Citation
 Annals of Surgical Oncology, Vol.25(11) : 3222-3230, 2018 
Journal Title
 Annals of Surgical Oncology 
ISSN
 1068-9265 
Issue Date
2018
Abstract
BACKGROUND: There is increasing interest in the influence of body composition on oncological outcomes. We evaluated the role of skeletal muscle and fat among patients with gastric cancer (GC) who underwent gastrectomy with or without adjuvant chemotherapy, as well as those changes' associations with survival outcomes. METHODS: The present study evaluated 136 patients with GC who were enrolled in the CLASSIC Trial at Yonsei Cancer Center. Baseline body compositions including skeletal muscle area, Hounsfield units (HU), visceral fat area, and subcutaneous fat area were measured by preoperative computed tomography (CT). CT before and after the gastrectomy were used to determine the 6-month relative changes in body composition parameters. Continuous variables were dichotomized according to the best cutoff values by Contal and O'Quigley method. RESULTS: Seventy-three patients (53.7%) underwent surgery alone, and 63 patients (46.3%) underwent surgery followed by adjuvant chemotherapy. The baseline body composition parameters were not associated with disease-free survival (DFS) or overall survival (OS). Except for the HU, the marked loss of muscle, visceral fat, or subcutaneous fat significantly predicted shorter DFS and OS. Patients with a marked loss in at least one significant body composition parameter had significantly shorter DFS (hazard ratio 2.9, 95% confidence interval 1.7-4.8, P < 0.001) and OS (hazard ratio 2.9, 95% confidence interval 1.7-5.0, P < 0.001). CONCLUSIONS: Marked loss in body composition parameters significantly predicted shorter DFS and OS among patients with GC who underwent gastrectomy. Postoperative nutrition and active healthcare interventions could improve the prognosis of these GC patients
Full Text
https://link.springer.com/article/10.1245%2Fs10434-018-6624-1
DOI
10.1245/s10434-018-6624-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김지형(Kim, Jee Hung) ORCID logo https://orcid.org/0000-0002-9044-8540
김형일(Kim, Hyoung Il) ORCID logo https://orcid.org/0000-0002-6134-4523
김효송(Kim, Hyo Song) ORCID logo https://orcid.org/0000-0002-0625-9828
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
박형순(Park, Hyung Soon)
백송이(Baek, Song Ee) ORCID logo https://orcid.org/0000-0001-8146-2570
범승훈(Beom, Seung Hoon) ORCID logo https://orcid.org/0000-0001-7036-3753
손태일(Son, Tae Il) ORCID logo https://orcid.org/0000-0002-0327-5224
임준석(Lim, Joon Seok) ORCID logo https://orcid.org/0000-0002-0334-5042
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
정재호(Cheong, Jae Ho) ORCID logo https://orcid.org/0000-0002-1703-1781
정현철(Chung, Hyun Cheol) ORCID logo https://orcid.org/0000-0002-0920-9471
최은아(Choe, Eun Ah) ORCID logo https://orcid.org/0000-0001-7700-8711
허수진(Heo, Su Jin) ORCID logo https://orcid.org/0000-0002-0615-5869
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163778
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