Background: Postoperative changes in body composition (BC) have not been clearly defined. The aim of this study was to clarify the impact of postoperative comprehensive changes in BC on long-term prognosis in gastric cancer (GC) patients. Methods: A total of 366 GC patients who underwent radical gastrectomy were included. Postoperative changes in skeletal muscle volume, body fat volume, and skeletal muscle density were investigated at six months postoperatively using computed tomography and evaluated their association with long-term survival. Results: Patients with decreased muscle volume, decreased fat volume, and increased muscle density had a poor prognosis, respectively. When the risk scores based on these three BC parameters were applied, patients were classified from score 0 to 4, with survival rate declining as the scores improved: score 0, interim 5-year overall survival 94%; score 1, 82%; score 2, 73%; score 3, 56%; and score 4, 20%. BC change (score > 2) was an independent poor prognosticator (HR, 3.086;p< 0.001). Preoperative myosteatosis, high Charlson comorbidity, and total gastrectomy were identified as significant independent risk factors for BC change. Conclusions: Each of postoperative skeletal muscle loss, body fat loss, and muscle hyperdensity negatively affected prognosis of GC patients after surgery, and the BC risk scoring assessment well predicted the prognosis of postoperative patients with GC.
背景：术后身体成分（BC）的变化尚未得到明确界定。本研究旨在阐明胃癌（GC）患者术后BC综合变化对长期预后的影响。方法：共纳入366例接受根治性胃切除术的GC患者。通过计算机断层扫描在术后六个月评估骨骼肌体积、体脂体积和骨骼肌密度的变化，并分析其与长期生存率的关系。结果：肌肉体积减少、脂肪体积减少及肌肉密度增加的患者预后均较差。基于这三项BC参数的风险评分将患者分为0至4分，随着评分升高生存率呈下降趋势：0分患者5年总生存率为94%；1分为82%；2分为73%；3分为56%；4分为20%。BC变化（评分>2）是独立的预后不良因素（风险比3.086，p<0.001）。术前肌脂肪变性、高查尔森合并症指数及全胃切除术被确定为BC变化的显著独立危险因素。结论：术后骨骼肌减少、体脂减少及肌肉密度增高均对GC患者术后预后产生负面影响，BC风险评分评估能有效预测GC术后患者的预后。
肿瘤(癌症)患者之家