Neoadjuvant chemotherapy (NT) followed by radical surgery is the standard treatment for locally advanced gastric cancer (GC). The incidence of sarcopenia in upper gastrointestinal tract malignancies is very high, and it may be increased after NT. This study aimed to evaluate the impact of NT on body composition. A retrospective study of patients with locally advanced GC undergoing gastrectomy who had received NT in a tertiary hospital between 2012 and 2019 was conducted. CT measured the skeletal muscle index, total psoas area, and visceral and subcutaneous adipose tissue before and after NT. Of the 180 gastrectomies for GC, 61 patients received NT. During NT, changes in body composition were observed with a decrease in the skeletal muscle mass index (SMMI −2.5%;p< 0.001), and these changes were significantly greater in men (SMMI −10.55%). Before surgery, patients who received NT presented 15% more sarcopenia than those without NT (p= 0.048). In conclusion, patients with locally advanced gastric cancer who receive NT have significant changes in body composition during chemotherapy. These changes, which are at the expense of a loss of muscle mass, lead to an increased incidence of pre-surgical sarcopenia.
新辅助化疗（NT）后行根治性手术是局部进展期胃癌（GC）的标准治疗方案。上消化道恶性肿瘤中肌肉减少症的发生率极高，且NT后可能进一步增加。本研究旨在评估NT对身体成分的影响。本研究回顾性分析了2012年至2019年间在一家三级医院接受胃切除术的局部进展期胃癌患者，所有患者均接受了NT。通过CT测量了NT前后患者的骨骼肌指数、总腰大肌面积以及内脏和皮下脂肪组织。在180例胃癌胃切除术中，有61例患者接受了NT。在NT期间，观察到身体成分发生变化，骨骼肌质量指数下降（SMMI −2.5%；p<0.001），且这些变化在男性中更为显著（SMMI −10.55%）。术前，接受NT的患者比未接受NT的患者肌肉减少症发生率高出15%（p=0.048）。总之，接受NT的局部进展期胃癌患者在化疗期间身体成分发生显著变化。这些变化以肌肉质量损失为代价，导致术前肌肉减少症发生率增加。
Impact of Neoadjuvant Treatment on Body Composition in Patients with Locally Advanced Gastric Cancer
肿瘤(癌症)患者之家