Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study.

Autor: Lascala F; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., da Silva Moraes BK; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., Mendes MCS; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., de Carvalho MB; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., Branbilla SR; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., da Cunha Júnior AD; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.; Hematology and Oncology Clinics, Cancer Hospital of Cascavel, União Oeste de Estudos e Combate ao Câncer (UOPECCAN), Cascavel, PR, Brazil.; Department of Internal Medicine, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil., Lopes LR; Division of Gastrointestinal Surgery, Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., Andreollo NA; Division of Gastrointestinal Surgery, Department of Surgery, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., Macedo LT; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil., Prado CM; Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada., Carvalheira JBC; Division of Oncology, Department of anesthesiology, oncology and radiology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil. jbcc@unicamp.br.
Jazyk: angličtina
Zdroj: European journal of clinical nutrition [Eur J Clin Nutr] 2023 Jan; Vol. 77 (1), pp. 116-126. Date of Electronic Publication: 2022 Sep 08.
DOI: 10.1038/s41430-022-01201-7
Abstrakt: Background/objectives: The association between systemic inflammation and myosteatosis upon diagnosis of gastric cancer (GC) and whether these factors could predict survival outcomes is not clear. Our aim was to explore the association between systemic inflammation and myosteatosis upon diagnosis of GC, specially whether the co-occurrence of these factors could predict survival outcomes.
Subjects/methods: Computed tomography (CT) was performed at the level of the third lumbar vertebra for body composition analysis in 280 patients with GC. Myoesteatosis was defined as the lowest tertile of the muscle radiodensity distribution or based on clinical significance using optimal stratification analysis. Inflammatory indexes were measured, including the neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte and lymphocyte-to-monocyte ratios.
Results: Patients with low skeletal muscle (SM) radiodensity were more likely to be older than 65 years, have a higher body mass index and have diabetes. They also had higher intermuscular visceral and subcutaneous adipose tissue areas and indexes. The highest tertile of SM radiodensity was associated with better disease-free survival (DFS) (HR = 0.51, 95% CI [0.31, 0.84], p trend  = 0.020) and overall survival (OS) (HR = 0.49, 95% CI [0.29, 0.82], p trend  = 0.022). Patients with NLR > 2.3 and myosteatosis had the worst DFS and OS (HR = 2.77, 95% CI [1.54, 5.00], p = 0.001; HR = 3.31, 95% CI [1.79, 6.15], p < 0.001, respectively).
Conclusion: Co-occurrence of myosteatosis and inflammation increased disease progression and death risk by almost three times. These regularly obtained biomarkers might improve prognostic risk prediction in resectable GC.
(© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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