Long-Term Outcome in Gastric Cancer Patients with Different Body Composition Score Assessed via Computed Tomography

J Invest Surg. 2021 Aug;34(8):875-882. doi: 10.1080/08941939.2019.1708997. Epub 2020 Jan 29.

Abstract

Background: The purpose of this study was to assess the body composition score (BCS) impact on 3-year survival after radical gastrectomy in patients with gastric cancer.

Methods: This retrospective study included patients with gastric cancer from September 2015 to June 2017. The patients were divided into three groups: BCS0 (having normal skeletal muscle or adipose mass), BCS1 (having low skeletal muscle mass only), and BCS2 (having low skeletal muscle and adipose mass) according to their third lumbar vertebra skeletal muscle index and fat index calculated using abdominal computed tomography. The clinicopathological indicators, postoperative complications, 3-year over survival (OS) rate after radical gastrectomy, and cause of death among the three groups were compared.

Results: A total of 187 patients were enrolled in the study, in which 102 patients (54.6%) had BCS0, 76 (40.6%) had BCS1 and 9 (4.8%) had BCS2. There was no significant difference in postoperative complications among the groups. 3-year OS was significantly shortened with each 1-score increase in BCS (Log-rank p < 0.001). Multivariate Cox regression analyses showed that no neoadjuvant chemotherapy, tumor stage III, BCS1, and BCS2 were independent prognostic factors for 3-year OS after radical gastrectomy. The main cause of death was cancer-related.

Conclusion: We demonstrated that BCS1 and BCS2 were strongly associated with poor 3-year survival for patients with gastric cancer who underwent radical gastrectomy, suggesting that special attention may be required for nutritional support while determining therapeutic strategies.

Keywords: adipose mass; body composition; computed tomography; gastric cancer; skeletal muscle mass.

MeSH terms

  • Body Composition
  • Gastrectomy / adverse effects
  • Humans
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms* / diagnostic imaging
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery
  • Tomography, X-Ray Computed