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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2024

Open Access 25-01-2024 | Gastric Cancer | Gastrointestinal Oncology

Predictive Value of a New Muscle Parameter in Patients with Resectable Gastric Cancer: A Pooled Analysis of Three Prospective Trials

Authors: Qing Zhong, MD, Jiao-Bao Huang, MD, Jun Lu, MD, PhD, Li-Wei Xue, MD, Guang-Tan Lin, MD, Jian-Wei Xie, MD, PhD, Jian-Xian Lin, MD, PhD, Chao-Hui Zheng, MD, PhD, Chang-Ming Huang, MD, Ping Li, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2024

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Abstract

Background

Sarcopenia is closely associated with gastric cancer (GC) prognosis. However, its exact definition remains controversial.

Methods

This study included computed tomography images and clinical data of patients from three prospective studies. The skeletal muscle index (SMI) and skeletal muscle radiation attenuation (SMRA) were analyzed, and a new muscle parameter, skeletal muscle gauge (SMG), was obtained by multiplying the two parameters. The values of the three indices for predicting the prognosis of patients with GC were compared.

Results

The study included 717 patients. The findings showed median values of 42 cm2/m2 (range, 36.8–48.2 cm2/m2) for SMI, 45 HU (range, 41–49 HU) for SMRA, and 1842 (range, 1454–2260) for SMG. Postoperatively, 111 patients (15.5%) experienced complications. The 3-year overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were 74.3%, 68.2%, and 70%, respectively. Univariate logistic analysis showed that postoperative complications were associated with SMI (odds ratio [OR] 0.94; 95% confidence interval [CI] 0.92–0.96), SMRA (OR, 0.87; 95% CI 0.84–0.90), and SMG (OR 0.99; 95% CI 0.98–0.99). After a two-step multivariate analysis, only SMG (OR 0.98, 95% CI 0.97–0.99) was an independent protective factor of postoperative complications. Multivariate analysis showed that SMG also was an independent protective factor of OS, DFS, and RFS. The patients were divided into low-SMG (L-SMG) group and high-SMG (H-SMG) groups. Chemotherapy benefit analysis of the patients with stage II low SMG showed that the OS, DFS, and RFS of the chemotherapy group were significantly better than those of the non-chemotherapy group (p < 0.05).

Conclusion

The prospective large sample data showed that the new muscle parameter, SMG, can effectively predict the short-term outcome and long-term prognosis of patients with resectable gastric cancer. As a new muscle parameter index, SMG is worthy of further study.
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Metadata
Title
Predictive Value of a New Muscle Parameter in Patients with Resectable Gastric Cancer: A Pooled Analysis of Three Prospective Trials
Authors
Qing Zhong, MD
Jiao-Bao Huang, MD
Jun Lu, MD, PhD
Li-Wei Xue, MD
Guang-Tan Lin, MD
Jian-Wei Xie, MD, PhD
Jian-Xian Lin, MD, PhD
Chao-Hui Zheng, MD, PhD
Chang-Ming Huang, MD
Ping Li, MD, PhD
Publication date
25-01-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-14913-w

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