Background/Objectives: This study aimed to investigate whether post-operative changes in the computed tomography (CT)-attenuation of subcutaneous (SAT) and visceral (VAT) adipose tissues were significantly associated with recurrence-free survival (RFS), peritoneal RFS, and overall survival (OS) in patients with stage II–III gastric cancer. Methods: This retrospective study analyzed 243 patients with stage II–III gastric cancer who underwent curative surgery. CT-attenuation values of SAT (SAT HU) and VAT (VAT HU) were measured from non-contrast-enhanced abdominopelvic CT images taken pre-operatively and 6 months post-operatively. Changes in SAT HU (ΔSAT HU) and VAT HU (ΔVAT HU) between the two CT scans were calculated. The prognostic value of these variables for predicting survival outcomes was assessed. Results: Correlation analyses showed that both ΔSAT HU and ΔVAT HU were significantly positively correlated with T stage, TNM stage, and tumor size (p< 0.05). In the multivariate survival analysis, ΔVAT HU emerged as an independent significant predictor for RFS (p= 0.002, hazard ratio, 2.437), peritoneal RFS (p= 0.023, hazard ratio, 2.457), and OS (p= 0.043, hazard ratio, 2.204) after adjusting for age, sex, histopathological classification, T stage, and N stage. Patients with high ΔVAT HU had worse RFS, peritoneal RFS, and OS compared to those with low ΔVAT HU. Conclusions: Change in CT-attenuation of VAT following surgery was significantly correlated with tumor characteristics and was a significant predictor of RFS, peritoneal RFS, and OS in patients with stage II–III gastric cancer.
背景/目的：本研究旨在探讨术后计算机断层扫描（CT）测得的皮下脂肪组织（SAT）和内脏脂肪组织（VAT）衰减值变化是否与II–III期胃癌患者的无复发生存期（RFS）、腹膜无复发生存期（腹膜RFS）及总生存期（OS）显著相关。方法：本回顾性研究纳入了243例接受根治性手术的II–III期胃癌患者。通过术前及术后6个月的非增强腹盆腔CT图像测量SAT（SAT HU）和VAT（VAT HU）的CT衰减值，并计算两次CT扫描间SAT HU（ΔSAT HU）和VAT HU（ΔVAT HU）的变化。评估这些变量对生存结局的预测价值。结果：相关性分析显示，ΔSAT HU和ΔVAT HU均与T分期、TNM分期及肿瘤大小呈显著正相关（p<0.05）。在多因素生存分析中，校正年龄、性别、组织病理学分型、T分期和N分期后，ΔVAT HU成为RFS（p=0.002，风险比2.437）、腹膜RFS（p=0.023，风险比2.457）和OS（p=0.043，风险比2.204）的独立显著预测因子。与ΔVAT HU较低的患者相比，ΔVAT HU较高的患者RFS、腹膜RFS和OS更差。结论：术后VAT的CT衰减值变化与肿瘤特征显著相关，是II–III期胃癌患者RFS、腹膜RFS和OS的重要预测指标。
肿瘤(癌症)患者之家