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Relationship between psoas muscle index and long-term survival in older patients aged ≥ 80 years after endoscopic submucosal dissection for gastric cancer

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Abstract

Background

In Japan, endoscopic submucosal dissection (ESD) has been widely performed for ESD-adapted gastric cancer, but little is known about the prognostic factors after ESD for gastric cancer in older patients. The psoas muscle index (PMI) is an indicator of sarcopenia calculated from computed tomography images and reportedly related to the prognosis of some diseases. This study aimed to explore factors related to long-term survival after ESD for gastric cancer in patients aged ≥ 80 years.

Methods

We retrospectively reviewed 88 patients (63 men, 25 women) with early gastric cancer who underwent ESD at ≥ 80 years. Possible factors related to death after gastric ESD were analyzed by univariate and multivariate analyses using a Cox proportional hazards model. The estimated overall survival (OS) was compared between the groups stratified by significant factors.

Results

The 5-year OS rate was 73.9% (median follow-up period, 5.4 years). In the multivariate analysis, a low PMI (< 6.36 in men, < 3.92 in women) (hazard ratio [HR] 2.89, 95% confidence interval [CI] 1.11–7.54) and high Charlson comorbidity index (CCI) (≥ 3) (HR 1.87, 95% CI 1.14–3.09) were independently related to death after ESD. The 5-year OS rates were significantly higher in the high PMI group (82.3% vs. 70.7%, P = 0.026) and the low CCI group (76.0% vs. 37.9%, P = 0.002).

Conclusion

In addition to low CCI, high PMI is a predictor of long-term survival after ESD for gastric cancer in patients aged ≥ 80 years.

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Data availability

The authors elect to not share the data.

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Funding

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Author information

Author notes

  1. Kohei Funasaka, Ryoji Miyahara & Yoshiki Hirooka

    Present address: Department of Gastroenterology and Hepatology, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Nobuhito Ito, Kohei Funasaka, Ryoji Miyahara, Kazuhiro Furukawa, Takeshi Yamamura, Takuya Ishikawa, Eizaburo Ohno, Masanao Nakamura & Mitsuhiro Fujishiro

  2. Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan

    Hiroki Kawashima & Yoshiki Hirooka

Authors
  1. Nobuhito Ito
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  2. Kohei Funasaka
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Contributions

Study concept and design: NI. Acquisition of subjects and/or data: KF, RM, KF, TY, TI, EO, MN, and HK. Data analysis and interpretation: YH and MF. Preparation of manuscript: NI and KF.

Corresponding author

Correspondence to Kohei Funasaka.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

This study was approved by the Ethics Committee of Nagoya University Hospital (IRB No. 2015-0485).

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Supplementary Information

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Supplementary file1 (DOCX 21 kb)

10147_2021_2112_MOESM2_ESM.docx

Supplementary file2 Figure S1. Measurement of PMI at the level of L3 vertebra on CT. PMI, psoas muscle index; CT, computed tomography. Figure S2. Disease-specific survival for each curability. Figure S3. Median PMI by sex. The median PMI of men was 4.96 (cm2/m2), whereas that for women was 3.85 (cm2/m2). PMI, psoas muscle index. Figure S4. Comparison of overall survival curves between the low and high PMI groups (divided PMI groups by median PMI by sex) (P=0.028). PMI, psoas muscle index (PPTX 280 kb)

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Cite this article

Ito, N., Funasaka, K., Miyahara, R. et al. Relationship between psoas muscle index and long-term survival in older patients aged ≥ 80 years after endoscopic submucosal dissection for gastric cancer. Int J Clin Oncol 27, 729–738 (2022). https://doi.org/10.1007/s10147-021-02112-6

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  • DOI: https://doi.org/10.1007/s10147-021-02112-6

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