Background/Objectives:Preoperative body composition has been implicated as a factor affecting clinical outcomes in several types of cancer. However, there is limited evidence regarding whether preoperative body composition can predict the prognosis following gastrectomy for gastric cancer (GC). We aimed to investigate the role of preoperative body composition as a prognostic factor for overall survival (OS) and relapse-free survival (RFS) after gastrectomy for GC.Methods:This prospective study included 540 patients who underwent gastrectomy for GC at the Kanagawa Cancer Center, Japan, between December 2013 and November 2017. Preoperative body composition was assessed using the skeletal muscle index and visceral adipose tissue area derived from computed tomography scans. Patients were classified into four groups: non-sarcopenic non-obesity (NN), sarcopenic non-obesity (SN), non-sarcopenic obesity (NO), and sarcopenic obesity (SO).Results:A total of 448 patients (NN, 184; SN, 52; NO, 186; SO, 26) were included in the final analysis. In terms of OS, the SO group showed significantly worse survival than the NN group (72.1% vs. 87.6%,p= 0.01). Similarly, regarding RFS, the SO group had significantly worse outcomes than the NN group (68.4% vs. 86.2%,p= 0.007). Multivariate analysis identified SO as an independent risk factor for both OS (hazard ratio [HR], 3.18; 95% confidence interval [CI], 1.33–7.64;p= 0.01) and RFS (HR, 3.08; 95% CI, 1.36–6.95;p= 0.01).Conclusions:Preoperative SO was associated with poorer outcomes in patients undergoing gastrectomy for GC.
背景/目的：术前身体成分已被证实是影响多种癌症临床结局的因素之一。然而，关于术前身体成分能否预测胃癌根治术后的预后，目前证据有限。本研究旨在探讨术前身体成分作为胃癌根治术后总生存期和无复发生存期预后因素的作用。
方法：这项前瞻性研究纳入了2013年12月至2017年11月期间在日本神奈川县癌症中心接受胃癌根治术的540例患者。通过计算机断层扫描获取骨骼肌指数和内脏脂肪面积以评估术前身体成分。患者被分为四组：非肌少症非肥胖组、肌少症非肥胖组、非肌少症肥胖组以及肌少症肥胖组。
结果：最终分析共纳入448例患者（非肌少症非肥胖组184例，肌少症非肥胖组52例，非肌少症肥胖组186例，肌少症肥胖组26例）。在总生存期方面，肌少症肥胖组的生存率显著低于非肌少症非肥胖组（72.1%对比87.6%，p=0.01）。同样，在无复发生存期方面，肌少症肥胖组的结果也显著差于非肌少症非肥胖组（68.4%对比86.2%，p=0.007）。多变量分析显示，肌少症肥胖是总生存期（风险比3.18，95%置信区间1.33-7.64，p=0.01）和无复发生存期（风险比3.08，95%置信区间1.36-6.95，p=0.01）的独立危险因素。
结论：术前存在肌少性肥胖与胃癌患者接受根治性切除术后的不良预后相关。
Effect of Preoperative Sarcopenic Obesity on Outcomes in Patients with Gastric Cancer After Surgery
肿瘤(癌症)患者之家