Impact of Preoperative Skeletal Muscle Quality Measurement on Long-Term Survival After Curative Gastrectomy for Locally Advanced Gastric Cancer
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Skeletal muscle quality is a prognostic factor in various cancers. However, similar studies on curatively resected gastric cancer are lacking. We evaluated skeletal muscle quality using intramuscular adipose tissue content (IMAC) to clarify its impact on survival in patients with locally advanced gastric cancer.
We reviewed 370 patients who underwent curative resection for stage II/III gastric cancer. IMAC was calculated using preoperative computed tomography images. IMAC cutoff values were determined for each sex and were set at the 75th percentile. The patients were classified into normal and high IMAC groups according to the cutoff values. Clinicopathological factors and survival outcomes were compared between the two groups. Multivariate Cox regression analysis was used to identify independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS).
In all, 277 patients were classified into the normal IMAC group and 93 were classified into the high IMAC group. The patients in the high IMAC group were older, more obese, and had more comorbidities and poor Eastern Cooperative Oncology Group performance status than those in the normal IMAC group. Although no significant differences were observed in the pathological findings between the two groups, a high IMAC was significantly associated with poor OS and CSS. Multivariate analysis identified high IMAC as an independent prognostic factor for both OS and CSS (p = 0.046 and p = 0.035, respectively).
High IMAC was significantly associated with poor survival, suggesting that skeletal muscle quality has oncological implications in patients with locally advanced gastric cancer.
The authors would like to thank Ryo Ashida for his helpful advice during this study.
The funding source was not involved in this study.
Compliance with ethical standards
Conflict of interest
Masanori Terashima has received personal fees from Taiho, Chugai, Ono, Bristol-Myers Squibb, Yakult, Takeda, Eli Lilly, Pfizer, and Daiichi Sankyo, outside the submitted work. All other authors declare no conflict of interest.
Human and animal rights
This study was approved by the institutional review board of Shizuoka Cancer Center (approval no. 29-J163-29-1-3).
Informed consent was not obtained from the patients. Instead, all patients were previously informed of an opt-out method.