Prognostic Significance of Sarcopenia in Patients with Esophagogastric Junction Cancer or Upper Gastric Cancer
Prognostic Significance of Sarcopenia in Patients with Esophagogastric Junction Cancer or Upper Gastric Cancer
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DOI：
10.1245/s10434-017-5811-9
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发表时间：
2017-07-01
影响因子：
3.7
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
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作者：
Kudou, Kensuke;Saeki, Hiroshi;Maehara, Yoshihiko
肌肉减少症与胃肠道恶性肿瘤患者术后结局之间的关系仍存在争议。本研究旨在评估肌减少症对食管胃交界处癌（EGJC）或胃上部癌（UGC）手术后短期和长期结局的影响。根据使用腹部计算机断层扫描图像计算的骨骼肌指数，将患者分为肌肉减少症组和非肌肉减少症组。比较两组患者的临床病理因素、术后并发症和预后，EGJC组中19例（32.2%）和UGC组中23例（25.8%）出现肌肉减少。肌肉减少症组的5年总生存率（OS）和无复发生存率（RFS）显著低于非肌肉减少症组（OS 85.5 vs 54.8%，P = 0.0010; RFS 78.7 vs 51.7%，P = 0.0054）。两组之间术后并发症的发生没有显著差异。单因素和多因素分析均显示，N分期（P < 0.0001）和肌肉减少（P = 0.0024和0.0293，分别）是OS的独立预后不良因素。结果表明，在制定治疗策略时，可能需要特别注意那些打算接受EGJC和UGC手术的肌肉减少症患者。
The association between sarcopenia and postoperative outcomes for patients with gastrointestinal malignancies remains controversial. This study aimed to assess the impact of sarcopenia on short- and long-term outcomes after surgery for esophagogastric junction cancer (EGJC) or upper gastric cancer (UGC).The study reviewed 148 patients with EGJC or UGC who underwent surgical resection. The patients were categorized into the sarcopenia group or the non-sarcopenia group according to their skeletal muscle index calculated using abdominal computed tomography images. The study compared clinicopathologic factors, postoperative complications, and prognosis between the two groups.Sarcopenia was present in 19 patients (32.2%) with EGJC and 23 patients (25.8%) with UGC. The 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly poorer in the sarcopenia group than in the non-sarcopenia group (OS 85.5 vs 54.8%, P = 0.0010; RFS 78.7 vs 51.7%, P = 0.0054). The development of postoperative complications did not differ significantly between the two groups. Both the uni- and multivariate analyses showed that N stage (P < 0.0001) and sarcopenia (P = 0.0024 and 0.0293, respectively) were independent poor prognostic factors for OS.Sarcopenia was strongly associated with a poor long-term prognosis for patients with EGJC or UGC who underwent surgery. The results suggest that special attention might be needed during the development of treatment strategies for patients with sarcopenia who intend to undergo operations for EGJC and UGC.