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

Research output: Contribution to journalArticle

8 Citations (Scopus)

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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Intra-Abdominal Fat
Subcutaneous Fat
Gastrectomy
Stomach Neoplasms
Body Composition
Muscles
Survival
Disease-Free Survival
Adjuvant Chemotherapy
Skeletal Muscle
Tomography
Confidence Intervals
Fats
Delivery of Health Care
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Park, Hyung Soon ; Kim, Hyo Song ; Beom, Seung Hoon ; Rha, Sun Young ; Chung, Hyun Cheol ; Kim, Jee Hung ; Chun, You Jin ; Lee, Si Won ; Choe, Eun Ah ; Heo, Su Jin ; Noh, Sung Hoon ; Hyung, Woo Jin ; Cheong, Jae Ho ; Kim, Hyoung Il ; Son, Taeil ; Lim, Joon Seok ; Baek, Song Ee ; Jung, Minkyu. / 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. In: Annals of surgical oncology. 2018 ; Vol. 25, No. 11. pp. 3222-3230.
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title = "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",
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.",
author = "Park, {Hyung Soon} and Kim, {Hyo Song} and Beom, {Seung Hoon} and Rha, {Sun Young} and Chung, {Hyun Cheol} and Kim, {Jee Hung} and Chun, {You Jin} and Lee, {Si Won} and Choe, {Eun Ah} and Heo, {Su Jin} and Noh, {Sung Hoon} and Hyung, {Woo Jin} and Cheong, {Jae Ho} and Kim, {Hyoung Il} and Taeil Son and Lim, {Joon Seok} and Baek, {Song Ee} and Minkyu Jung",
year = "2018",
month = "10",
day = "1",
doi = "10.1245/s10434-018-6624-1",
language = "English",
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pages = "3222--3230",
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Park, HS, Kim, HS, Beom, SH, Rha, SY, Chung, HC, Kim, JH, Chun, YJ, Lee, SW, Choe, EA, Heo, SJ, Noh, SH, Hyung, WJ, Cheong, JH, Kim, HI, Son, T, Lim, JS, Baek, SE & 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, vol. 25, no. 11, pp. 3222-3230. https://doi.org/10.1245/s10434-018-6624-1

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

In: Annals of surgical oncology, Vol. 25, No. 11, 01.10.2018, p. 3222-3230.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Marked Loss of Muscle, Visceral Fat, or Subcutaneous Fat After Gastrectomy Predicts Poor Survival in Advanced Gastric Cancer

T2 - Single-Center Study from the CLASSIC Trial

AU - Park, Hyung Soon

AU - Kim, Hyo Song

AU - Beom, Seung Hoon

AU - Rha, Sun Young

AU - Chung, Hyun Cheol

AU - Kim, Jee Hung

AU - Chun, You Jin

AU - Lee, Si Won

AU - Choe, Eun Ah

AU - Heo, Su Jin

AU - Noh, Sung Hoon

AU - Hyung, Woo Jin

AU - Cheong, Jae Ho

AU - Kim, Hyoung Il

AU - Son, Taeil

AU - Lim, Joon Seok

AU - Baek, Song Ee

AU - Jung, Minkyu

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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.

AB - 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.

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U2 - 10.1245/s10434-018-6624-1

DO - 10.1245/s10434-018-6624-1

M3 - Article

C2 - 30051367

AN - SCOPUS:85050699621

VL - 25

SP - 3222

EP - 3230

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 11

ER -