Effect of sarcopenia on prognosis of patients with gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 192-192
Author(s):  
Shiro Iwagami ◽  
Hideo Baba
Keyword(s):  
Gastric Cancer ◽  
Muscle Mass ◽  
Proximal Gastrectomy ◽  
Disease Free Survival ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Cancer Specific Survival ◽  
Preoperative Ct ◽  
The Impact ◽  
The Relationship

192 Background: Recently, some studies reported the correlation between low skeletal muscle mass (sarcopenia) of patients with cancer and poor prognosis. There were no reports mentioned the relationship of sarcopenia to patients with gastric cancer. Objective: To evaluate the impact of sarcopenia on survival of patients with gastric cancer. Methods: From April 2005 to December 2010, 243 patients with gastric cancer underwent gasrectomy. Patients were divided in two groups, sarcopenia and nonsarcopenia group. Sarcopenia was defined as muscle mass below the median on preoperative CT scan. Muscle mass was assessed by psoas muscle density and total psoas area. The third lumbar vertebra (L3) was chosen as the standard landmark. We examined the relationship between sarcopenia and overall survival (OS), cancer specific survival (CSS), and disease free survival (DFS). Results: The mean age was 67.6 years old. 95 patients underwent total gastrectomy, 150 did distal gastrectomy, and 18 did proximal gastrectomy. The number of laparoscopic surgery was 62 cases. The CSS and DFS of patients in sarcopenia group were significantly shorter than nonsarcopenia group (p=0.012, p=0.023). The OS of sarcopenia tented to shorter (p=0.12). Conclusions: The presence of sarcopenia was found to significantly increase a patient’s risk of gastric cancer.

The impact of sarcopenia on transplant-related complications and number of days spent in the hospital in patients with lymphoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7044-7044
Author(s):  
Megan Veresh Caram ◽  
Daniel R. Couriel ◽  
Jennifer J. Griggs ◽  
Emily Light Bellile ◽  
Michael Englesbe
Keyword(s):  
Muscle Mass ◽  
Karnofsky Performance Status ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Hospital Treatment ◽  
Cell Transplant ◽  
Complication Rates ◽  
Hematopoietic Stem ◽  
Co Morbidity ◽  
The Impact

7044 Background: Sarcopenia, a state of abnormally low muscle mass, has been found to be associated with more treatment-related complications and shorter overall survival in patients with different cancers. Sarcopenia can be reliably assessed with routine computerized tomography (CT). The objectives of the study were to determine whether sarcopenia is associated with the number of complications and the number of days spent in the hospital in patients undergoing autologous hematopoietic stem cell transplantation (autoSCT) for lymphoma. Methods: Adult patients treated for non-Hodgkin's or Hodgkin's lymphoma with autoSCT between 2/2005 – 6/2/2012 at the University of Michigan (U-M) Bone Marrow Transplant (BMT) Program were eligible for inclusion if a CT of the abdomen was performed within 60 days prior to autoSCT. Total psoas area and lean psoas area were calculated for each patient with cross-sectional area and density measurements taken at the level of the fourth lumbar vertebra using algorithms programmed in the Analytic Morphomics Lab at U-M. All analyses were completed using Poisson regression models controlling for age, gender, body mass index, Hematopoeitic-Cell Transplant Co-morbidity Index (HCT-CI), and Karnofsky performance status (KPS). Results: Total and lean psoas area were calculated in the 121 patients who met inclusion criteria. Men with greater psoas muscle measures experienced fewer complications and spent fewer days in the hospital during the autoSCT admission compared to men who were sarcopenic (complications β = -0.206, p=0.001; hospital treatment days β = -0.043, p=0.029). Sarcopenia did not play a role in outcomes in women. A strong association existed between sarcopenia and re-admission days within 100 days following autoSCT among both men (β = -1.183, p<0.0001) and women (β = -0.805, p<0.0001). Conclusions: Muscle mass is independently associated with complication rates and duration of hospitalization in patients undergoing autoSCT for lymphoma. CT-determined psoas muscle mass may be a valuable addition to other indices used to guide optimal treatment selection and serve as a potentially modifiable host factor to improve transplant-related outcomes.

Clinical implication of psoas muscle mass measurement for predicting death within 3 months in patients with incurable uterine cervical or corpus malignancy

2021 ◽  
Author(s):  
Hiroyuki Kurosu ◽  
Yukiharu Todo ◽  
Ryutaro Yamada ◽  
Kaoru Minowa ◽  
Tomohiko Tsuruta ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Muscle Mass ◽  
Cancer Cachexia ◽  
Mass Measurement ◽  
Characteristic Curve ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Data Set ◽  
Cutoff Value ◽  
Computed Tomography Images

Abstract Objective The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. Methods We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into &gt;3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left–right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). Results A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at &gt;3 months before death and ≤3 months before death were −1.3 and −20.1%, respectively (P &lt; 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of −13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715–0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. Conclusions Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.

scholarly journals The Impact of Sports Magazine Consumption on Mesomorphic Body Standards and Self-sexualizing Behaviors: A Panel Study of Preadolescent Boys

2018 ◽  
Vol 23 (2) ◽  
pp. 368-394 ◽  
Author(s):  
Ann Rousseau ◽  
Jennifer Stevens Aubrey ◽  
Steven Eggermont
Keyword(s):  
Social Cognitive Theory ◽  
Muscle Mass ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Panel Study ◽  
Reward Sensitivity ◽  
The Impact ◽  
The Relationship ◽  
Moderating Role

The present three-wave panel study of 496 preadolescent boys ( Mage = 11.36, SD = 1.07) examined the impact of sports magazine consumption on mesomorphic body standards and self-sexualizing behaviors (e.g., drinking shakes in order to gain muscle mass, choosing clothing to show off muscles). Grounded in social cognitive theory, we also examined the moderating role of reward sensitivity. Results revealed that boys who consumed more sports magazines at wave 1 (W1) were more likely to report personal mesomorphic standards and perceived mesomorphic standards for men and boys in general at wave 2 (W2). Additionally, W2 personal mesomorphic standards mediated the relationship between sports magazine consumption at W1 and self-sexualizing behaviors at wave 3. Reward sensitivity moderated the relationship between personal mesomorphic standards and self-sexualizing behaviors.

scholarly journals The Incidence of Postoperative Complications after Gastrectomy Increases in Proportion to the Amount of Preoperative Visceral Fat

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Kazuyuki Okada ◽  
Tatsuto Nishigori ◽  
Kazutaka Obama ◽  
Shigeru Tsunoda ◽  
Koya Hida ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Visceral Fat ◽  
Visceral Obesity ◽  
Continuous Variable ◽  
University Hospital ◽  
Curative Gastrectomy ◽  
Visceral Fat Area ◽  
The Impact ◽  
The Relationship

Background. Visceral obesity is a risk factor for complications after gastrectomy in patients with gastric cancer. However, it is unclear whether postoperative complications decrease with preoperative reduction of visceral fat without the achievement of a nonobese state. This is because previous studies have performed categorical comparisons of obesity and nonobesity. The current study was performed to estimate the impact of the preoperative visceral fat area (VFA) as a continuous variable on postoperative complications after gastrectomy. Methods. Consecutive patients with gastric cancer who underwent curative gastrectomy between June 2006 and August 2017 at the Kyoto University Hospital were included in this retrospective study. The VFA at the level of the umbilicus was measured using preoperative computed tomography. The relationship between postoperative complications and VFA was investigated with univariate and multivariate analyses. Results. total of 566 patients were included in the study. Their mean VFA was 110 ± 58 cm2, and postoperative complications occurred in 121 patients (21.4%). The larger the VFA (<50, 50–99, 100–149, and ≥150 cm2), the higher the incidence of postoperative complications (11%, 14%, 21%, and 38%, respectively, P<0.001). Multivariate logistic regression analyses showed that the VFA was associated with postoperative complications (odds ratio: 1.009, 95% confidence interval (CI): 1.004–1.013, P<0.001), with an incidence of postoperative complications that was 9% (95% CI: 4%–12%) higher for every 10 cm2 increase in the VFA. Conclusion. The incidence of postoperative complications after gastrectomy increases in proportion to an increase in the preoperative VFA.

The impact of time to adjuvant chemotherapy (AC) on survival in colorectal cancer (CRC): A systematic review and meta-analysis.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 364-364 ◽  
Author(s):  
J. J. Biagi ◽  
M. Raphael ◽  
W. D. King ◽  
W. Kong ◽  
W. J. Mackillop ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Publication Bias ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Significant Heterogeneity ◽  
Risk Of Death ◽  
The Impact ◽  
The Relationship

364 Background: The optimal timing from CRC surgery to initiation of AC is unknown. We report a systematic review and meta-analysis to determine the relationship between time to adjuvant chemotherapy (TTAC) and survival. Methods: A systematic review of literature was done to identify studies that described the relationship between TTAC and survival. Studies were only included if the distribution of relevant prognostic factors was adequately described, and either comparative groups were balanced or results adjusted for the prognostic factors. Hazard ratio (HR) and TTAC for overall survival (OS) and disease free survival (DFS) from each study were converted to a regression coefficient (β) and standard error (SE) corresponding to a continuous representation per 4 weeks of TTAC. The adjusted β from individual studies were combined using a fixed-effect model. Inverse-variance (1/SE2) was used to weight individual studies. The possible effect of publication bias was investigated using the trim and fill approach. Results: We identified 9 eligible studies involving 14,357 patients (4 published articles, 5 abstracts). Two studies were randomized trials and 7 were cohort studies. Six studies reported TTAC as a binary variable and 3 reported TTAC as ≥3 categories. An estimate of HR for OS was derived from all 9 studies and estimate for DFS was derived from 5 studies. Meta-analysis demonstrated that a 4-week increase in TTAC was associated with a significant decrease in both OS (HR = 1.12, 95% CI 1.09-1.15), and DFS (HR = 1.15, 95% CI 1.11-1.20). The analysis showed no significant heterogeneity among studies. These TTAC associations remained significant after analysis for potential publication bias, and when the analysis was repeated excluding the two studies of largest weight. Conclusions: This study demonstrates a 12% increase in the risk of death for each 4 week of delay in the start of AC for CRC. These findings indicate the need for clinicians and health systems managers to take the steps necessary to keep TTAC as short as reasonably achievable. In addition, our results suggest there may be some benefit to AC after a 3-month TTAC delay. No significant financial relationships to disclose.

Impact of intramuscular fat accumulation on survival in stage II/III gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 19-19
Author(s):  
Yuhei Waki ◽  
Rie Makuuchi ◽  
Tomoyuki Irino ◽  
Satoshi Kamiya ◽  
Yutaka Tanizawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Subcutaneous Fat ◽  
Lumbar Vertebra ◽  
Intramuscular Fat ◽  
Stage Ii ◽  
Youden Index ◽  
Fat Accumulation ◽  
The Impact

19 Background: Intramuscular fat accumulation of skeletal muscle has been reported to be a prognostic factor in various cancers. To evaluate the intramuscular steatosis, intramuscular adipose tissue content (IMAC) measured by CT scan is thought to be an ideal method. However, this kind of study is very limited in curatively resected gastric cancer. So, this study was aimed to clarify the impact of IMAC on survival in stage II/III gastric cancer (GC). Methods: A total of 383 patients with pathological stage II/III GC after curative gastrectomy between January 2009 and December 2013 were included. IMAC was calculated by dividing the CT value of the multifidus muscles with that of the subcutaneous fat at the level of third lumbar vertebra. The IMAC cut-off values associated with cancer-specific survival (CSS) were separated by sex based on the maximum values of Youden index (sensitivity + specificity -1). Patients were classified into normal or high IMAC group according to this cut-off value. Clinicopathological factors and survival outcomes were compared between the two groups. Results: The median values of IMAC were -0.327 (IQR: -0.404- -0.250) in male and -0.239 (IQR: -0.335- -0.114) in female. The cut-off values of IMAC were -0.345 in male and -0.126 in female. Patients were classified into normal IMAC group (n = 204) and high IMAC group (n = 179). Patients in the high IMAC group were elderly, male, obese, having many comorbidities and with poor ECOG-PS compared to those in the normal IMAC group. Interestingly, despite the fact that no significant differences were observed in the pathological findings between the groups, the overall survival and CSS were significantly worse in the high IMAC group than in the normal IMAC group (p < 0.001 and p = 0.035). Moreover, the high IMAC was identified as an independent prognostic factor not only for overall survival but also for CSS (HR: 1.440, p = 0.021, HR: 1.646, p = 0.008, respectively). Conclusions: The high IMAC was significantly associated with worse survival, suggesting that IMAC represents certain oncological implications in patients with GC. Therefore, IMAC could be used as a new prognostic factor in curatively resected GC.

Clinical impact of postgastrectomy sarcopenia on the prognosis in patients with gastric cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 311-311
Author(s):  
Beom Jin Kim ◽  
Eun Sun Lee ◽  
Joong-Min Park ◽  
In Gyu Hwang
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Muscle Mass ◽  
Surgical Resection ◽  
Disease Free Survival ◽  
Clinical Impact ◽  
Free Survival ◽  
Significant Difference ◽  
Fat Volume ◽  
Disease Free

311 Background: There is a lack of research on newly developed sarcopenia postoperatively. The purpose of this study was to investigate the risk factors and the clinical impact of postgastrectomy sarcopenia on the prognosis in patients undergoing radical gastrectomy for gastric cancer (GC). Methods: We retrospectively reviewed clinicopathological data from 430 consecutive GC patients who underwent surgical resection at Chung-Ang University Hospital between January 2011 and December 2015. Their skeletal muscle mass and abdominal fat volume were measured by abdominal CT imaging. Results: A total of 425 patients were analyzed in the study. The mean age was 62 years old and male were 301 (70.8%). Of these, 42 patients (9.9%) were diagnosed as pre-operative sarcopenia. Compared with non-sarcopenic group, pre-operative sarcopenia groups showed more female, higher BMI, less alcoholic, and less smoking. However, there was no significant difference in 5 - year overall survival and disease free survival between the groups (p = 0.836 and p = 0.638, respectively). Among 381 non-sarcopenic patients, 48 patients (12.6%) were diagnosed as newly developed sarcopenia in one year after gastric resection. Compared with non-sarcopenic group, the newly developed sarcopenic group showed more male, more undifferentiated tumor, lower hemoglobin level, less alcoholic, less smoking, and presence of diabetes mellitus. However, there was no significant difference in the 5 - year overall survival and disease free survival among non-sarcopenic, sarcopenic, and newly developed sarcopenic groups (p = 0.521 and p = 0.534, respectively). The relationship between preoperative body fat volume and postoperative muscle mass showed a significant correlation (rho = 0.296, p < 0.001), but only BMI was significantly associated with long term survival. Conclusions: Although newly developed sarcopenia after surgery did not affect the survival rate, patients with nutritional risk of sarcopenia after surgical resection may require early evaluation of nutritional status and nutritional support.

Impact of intraoperative staging of gastric cancer on long-term survival.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 302-302
Author(s):  
Keisuke Koumori ◽  
Kazuki Kano ◽  
Hayato Watanabe ◽  
Yota Shimoda ◽  
Hirohito Fujikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Negative Impact ◽  
Tnm Classification ◽  
Clinical Stage ◽  
Term Survival ◽  
Long Term Survival ◽  
Preoperative Stage ◽  
The Impact ◽  
The Relationship

302 Background: The preoperative stage and intraoperative stage of gastric cancer were unified as the clinical stage in the 8th edition of the TNM classification (UICC). Although there are some reports about the relationship between preoperative stage and prognosis, the relationship between intraoperative stage and prognosis remains unclear. The aim of this study was to clarify the impact of intraoperative diagnosis and staging on long-term survival. Methods: Overall survivals were examined in 915 patients who underwent curative resection for gastric adenocarcinoma between April 2011 and March 2019 in our hospital. Results: The median age of the patients was 69 years (27-90 years), including 585 male and 330 female. The median follow-up period was 33.6 months (0.1-86.7 months). The number of the patients according to intraoperative stage were 641(70.1 %) in stageI, 15(1.6%) in stageIIA, 135(14.8%) in stageIIB, 111(12.1%) in stageIII, 12(1.3%) in stageIVA and 1(0.1%) in stageIVB. The hazard ratios of intraoperative stage for overall survival were as follows (ref: StageI); StageIIA, 6.990 (95% CI: 2.473-19.760, p < 0.001), StageIIB, 2.234 (95% CI: 1.220-4.092, p = 0.009), StageIII, 4.091 (95% CI: 2.416-6.928, p < 0.001), StageIVA, 6.061 (95% CI: 2.150-17.080, p < 0.001), StageIVB, 14.92 (95% CI: 2.035-109.3, p = 0.008). Conclusions: The survival of intraoperative StageIIA was poorer than StageIIB/III. Intraoperative positive lymph node metastasis could be negative impact of survival, even if tumor invasion was T1 or T2.

scholarly journals Depletion of skeletal muscle mass adversely affects long-term outcomes for men undergoing gastrectomy for gastric cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256365
Author(s):  
Katsunobu Sakurai ◽  
Naoshi Kubo ◽  
Yutaka Tamamori ◽  
Naoki Aomatsu ◽  
Takafumi Nishii ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Independent Predictor ◽  
Major Complication ◽  
Cancer Specific Survival ◽  
Skeletal Muscle Index ◽  
Lumbar Vertebral Body ◽  
Grade 3

Background Although low skeletal muscle mass has an adverse impact on the treatment outcomes of cancer patients, whether the relationship between preoperative skeletal muscle mass and gastrectomy outcomes in gastric cancer (GC) differs between men and women is unclear. The study aimed to clarify this relationship based on gender. Methods Between January 2007 and December 2015, 1054 patients who underwent gastrectomy for GC at Osaka City General Hospital were enrolled in this study. We evaluated sarcopenia by the skeletal muscle index (SMI), which was measured by computed tomography (CT) using areas of muscle in the third lumbar vertebral body (L3). Male and female patients were each divided into two groups (low skeletal muscle and high skeletal muscle). Results The SMI emerged as an independent predictor of 5-year overall survival (OS) in male GC patients (Hazard ratio 2.51; 95% confidence interval (CI) 1.73–3.63, p < 0.001) based on multivariate analysis. However, this index was not an independent predictive determinant of 5-year cancer-specific survival (CSS). The SMI was not an independent predictor of either OS or CSS in female GC patients. The incidence of leakage and major complication (Clavien Dindo grade ≧ 3) did not differ significantly across groups. Conclusions Preoperative skeletal muscle mass is a valuable prognostic predictor of OS in male GC patients.

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