Marked Loss of Muscle, Visceral Fat, or Subcutaneous Fat After Gastrectomy Predicts Poor Survival in Advanced Gastric Cancer: Single-Center Study from the CLASSIC Trial

Hyung Soon Park, Hyo Song Kim, Seung Hoon Beom, Sun Young Rha, Hyun Cheol Chung, Jee Hung Kim, You Jin Chun, Si Won Lee, Eun Ah Choe, Su Jin Heo, Sung Hoon Noh, Woo Jin Hyung, Jae Ho Cheong, Hyoung Il Kim, Taeil Son, Joon Seok Lim, Song Ee Baek, Minkyu Jung

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Abstract

Background: There is increasing interest in the influence of body composition on oncological outcomes. We evaluated the role of skeletal muscle and fat among patients with gastric cancer (GC) who underwent gastrectomy with or without adjuvant chemotherapy, as well as those changes’ associations with survival outcomes. Methods: The present study evaluated 136 patients with GC who were enrolled in the CLASSIC Trial at Yonsei Cancer Center. Baseline body compositions including skeletal muscle area, Hounsfield units (HU), visceral fat area, and subcutaneous fat area were measured by preoperative computed tomography (CT). CT before and after the gastrectomy were used to determine the 6-month relative changes in body composition parameters. Continuous variables were dichotomized according to the best cutoff values by Contal and O’Quigley method. Results: Seventy-three patients (53.7%) underwent surgery alone, and 63 patients (46.3%) underwent surgery followed by adjuvant chemotherapy. The baseline body composition parameters were not associated with disease-free survival (DFS) or overall survival (OS). Except for the HU, the marked loss of muscle, visceral fat, or subcutaneous fat significantly predicted shorter DFS and OS. Patients with a marked loss in at least one significant body composition parameter had significantly shorter DFS (hazard ratio 2.9, 95% confidence interval 1.7–4.8, P < 0.001) and OS (hazard ratio 2.9, 95% confidence interval 1.7–5.0, P < 0.001). Conclusions: Marked loss in body composition parameters significantly predicted shorter DFS and OS among patients with GC who underwent gastrectomy. Postoperative nutrition and active healthcare interventions could improve the prognosis of these GC patients.

Original languageEnglish
Pages (from-to)3222-3230
Number of pages9
JournalAnnals of surgical oncology
Volume25
Issue number11
DOIs
Publication statusPublished - 2018 Oct 1

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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Park, H. S., Kim, H. S., Beom, S. H., Rha, S. Y., Chung, H. C., Kim, J. H., Chun, Y. J., Lee, S. W., Choe, E. A., Heo, S. J., Noh, S. H., Hyung, W. J., Cheong, J. H., Kim, H. I., Son, T., Lim, J. S., Baek, S. E., & Jung, M. (2018). Marked Loss of Muscle, Visceral Fat, or Subcutaneous Fat After Gastrectomy Predicts Poor Survival in Advanced Gastric Cancer: Single-Center Study from the CLASSIC Trial. Annals of surgical oncology, 25(11), 3222-3230. https://doi.org/10.1245/s10434-018-6624-1