Myosteatosis predicts prognosis after radical gastrectomy for gastric cancer: A propensity score–matched analysis from a large-scale cohort
| Autor: | Feng-Min Zhang, Xi-Yi Chen, Zhen Yu, Su-Lin Wang, Liang-Liang Ma, Yang-Yang Huang, Xian Shen, Xiao-Lei Chen, Cheng-Le Zhuang |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Sarcopenia medicine.medical_specialty Comorbidity Kaplan-Meier Estimate Multimodal Imaging Gastroenterology Cohort Studies Gastrectomy Stomach Neoplasms Internal medicine medicine Humans Risk factor Propensity Score Aged Neoplasm Staging Proportional Hazards Models Aged 80 and over business.industry Proportional hazards model Cancer Middle Aged Prognosis medicine.disease Propensity score matching Cohort Body Composition Female Surgery Tomography X-Ray Computed business Cohort study |
| Zdroj: | Surgery. 166:297-304 |
| ISSN: | 0039-6060 |
| Popis: | Background Increasing evidence has suggested that sarcopenia is linked with cancer prognosis, but only limited data have focused on the impact of myosteatosis on cancer outcomes. This study evaluates the influence of myosteatosis on postoperative complications and survival in those patients who underwent radical resection of gastric carcinoma. Methods Patients who underwent elective radical gastrectomy for gastric cancer and had computed tomographic images available were identified from a prospectively collected database between 2008 and 2013. Myosteatosis was diagnosed by the cutoff values obtained from the method of optimum stratification. To obtain 2 well-balanced cohorts for available variables influencing clinical outcomes, the myosteatosis group was matched 1:1 with nonmyosteatosis group by using a propensity score match. Results Of 973 patients, 584 were matched for analyses. Compared with the nonmyosteatosis group, the myosteatosis group manifested significantly higher severe postoperative complications rates, shorter overall survival, and disease-free survival. Before matching, multivariate analyses identified that myosteatosis was an independent risk factor for severe postoperative complications, and Cox proportions hazards model showed that myosteatosis was an independent predictor for shorter overall survival and disease-free survival. In addition, subgroup analyses of each muscle phenotype showed that patients with both sarcopenia and myosteatosis had a poorer overall survival and disease-free survival than other patients. Conclusion Myosteatosis in gastric cancer is associated with poor prognosis. Classifying the skeletal muscle into subranges of radio density is a promising strategy to understand the impact of skeletal muscle on unfavorable surgical outcomes in gastric cancer patients. |
| Databáze: | OpenAIRE |
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