Frequency and prognostic impact of cachexia during drug treatment for unresectable advanced gastric cancer patients
Frequency and prognostic impact of cachexia during drug treatment for unresectable advanced gastric cancer patients
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DOI：
10.1007/s00595-022-02493-9
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发表时间：
2022-03-24
期刊：
影响因子：
2.5
通讯作者：
Hanazaki, Kazuhiro
中科院分区：
文献类型：
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作者：
Namikawa, Tsutomu;Marui, Akira;Hanazaki, Kazuhiro
目的不能手术切除的晚期转移性胃癌患者预后差。本研究探讨了恶病质的发生率和预后的影响，在系统药物治疗的患者。方法我们招募了2007年至2020年在高知医学院接受化疗的不可切除的晚期胃癌患者。癌症恶病质定义为过去6个月内体重减轻> 5%或体重减轻> 2%，体重指数< 20 kg/m2。分析了临床病理参数、癌症恶病质和总生存率之间的关系。结果134例患者化疗后6个月发生恶病质的发生率为55.2%。初治不能切除的胃癌恶病质发生率明显高于根治性切除术后复发的胃癌。化疗开始后6个月时，有恶病质的患者中位总生存期显著低于无恶病质的患者（13.7个月vs.21.6个月，P = 0.032）。在多变量分析中，开始治疗6个月时的癌症恶病质和CRP > 0.14被确定为与不良结局显著相关（风险比[HR] 1.339，95%置信区间[CI] 1.160-2.085，P = 0.019; HR 1.885，95% CI 1.124-3.161，P = 0.016）。结论癌性恶病质是不能手术的进展期胃癌患者化疗后常见的并发症，可作为判断预后的一个重要指标。
Purpose Patients with unresectable advanced metastatic gastric cancer have a poor prognosis. This study examined the incidence and prognostic impact of cachexia during systemic drug treatment in such patients. Methods We enrolled patients with unresectable advanced gastric cancer who were treated with chemotherapy at Kochi Medical School from 2007 to 2020. Cancer cachexia was defined as > 5% weight loss or > 2% weight loss with a body mass index of < 20 kg/m(2) within the past 6 months. Associations between clinicopathological parameters, cancer cachexia, and the overall survival were analyzed. Results Cancer cachexia occurred in 55.2% of 134 enrolled patients 6 months after chemotherapy. The incidence of cancer cachexia in initial unresectable gastric cancer was significantly higher than that in patients with recurrent cancer after curative resection. The median overall survival was significantly lower in the patients with cancer cachexia than in those without cancer cachexia at 6 months after starting systemic chemotherapy (13.7 months vs. 21.6 months, P = 0.032). Cancer cachexia at 6 months of starting treatment and CRP > 0.14 were identified as significantly associated with poor outcomes in a multivariate analysis (hazard ratio [HR] 1.339, 95% confidence interval [CI] 1.160-2.085, P = 0.019; HR 1.885, 95% CI 1.124-3.161, P = 0.016); respectively). Conclusions Cancer cachexia was frequently observed in unresectable advanced gastric cancer patients who received chemotherapy and was useful as a prognostic factor for the overall survival.