Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy
Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy
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DOI：
10.1007/s10120-014-0365-z
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发表时间：
2015-04-01
期刊：
影响因子：
7.4
通讯作者：
Sekimoto, Mitsugu
中科院分区：
文献类型：
--
作者：
Yamaoka, Yusuke;Fujitani, Kazumasa;Sekimoto, Mitsugu
骨骼肌损失与身体残疾、医院感染、术后并发症和生存率下降有关。防止胃切除术后骨骼肌质量的损失可能会改善结果。本研究的目的是评估全胃切除术（TG）后骨骼肌质量的变化，并阐明影响TG后骨骼肌显着损失的临床因素。102名因原发性胃癌接受TG的患者在TG前和TG后1年接受腹部计算机断层扫描，以精确量化术后骨骼肌和脂肪组织的变化。单变量和多变量逻辑回归分析确定了导致 TG 后骨骼肌显着损失的临床因素。TG 后 1 年，骨骼肌和脂肪组织的质量分别减少了术前值的 6.20 +/- A 6.80 和 65.8 +/- A 36.1 %，26 名患者 (25.5 %) 的骨骼肌显着损失超过10%。千分之一日元的 S-1 辅助化疗 6 个月（风险比 26.61，95% 置信区间，3.487-203.1）被确定为骨骼肌显着损失的单一独立危险因素。TG 后延长辅助化疗加剧了骨骼肌损失。进一步的研究应该确定适当的营养干预措施，以维持骨骼肌质量并改善结果。
Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG.One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG.At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20 +/- A 6.80 and 65.8 +/- A 36.1 % of the preoperative values, respectively, and 26 patients (25.5 %) showed a significant loss of skeletal muscle of more than 10 %. Adjuvant chemotherapy with S-1 for a parts per thousand yen6 months (hazard ratio 26.61, 95 % confidence interval, 3.487-203.1) was identified as the single independent risk factor for a significant loss of skeletal muscle.Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes.