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Surgery Today
Published in: Surgery Today 3/2024

01-08-2023 | Underweight | Original Article

Prognostic significance of the cachexia index in patients with unresectable advanced gastric cancer receiving palliative chemotherapy: a retrospective single-center study

Authors: Tomoyuki Matsunaga, Hiroaki Satio, Yu Sakano, Masahiro Makinoya, Shota Shimizu, Yuji Shishido, Kozo Miyatani, Takehiko Hanaki, Kyoichi Kihara, Manabu Yamamoto, Naruo Tokuyasu, Shuichi Takano, Teruhisa Sakamoto, Toshimichi Hasegawa, Yoshiyuki Fujiwara

Published in: Surgery Today | Issue 3/2024

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Abstract

Purpose

To investigate the prognostic utility of the cachexia index (CXI) in unresectable advanced gastric cancer (UAGC).

Methods

The relationship between CXI and the outcomes was evaluated in 102 patients with UAGC who had received first-line palliative 5-fluorouracil-based chemotherapy between January 2012 and December 2021.

Results

The median survival time (MST) from first-line chemotherapy initiation was 16.2 months, and the cohort included 60 and 42 patients with high and low CXIs, respectively, based on the optimal CXI cutoff. The rates of patients with a performance status score of 0, recurrence, third-line chemotherapy, and all grade 3–4 side effects, including febrile neutropenia (FN), were significantly higher in the CXIhigh group than in the CXIlow group. The prognosis based on MST was significantly better in the CXIhigh group than in the CXIlow group (22.5 vs. 11.6 months, p < 0.001). According to a multivariate analysis, a low CXI and performance status score of 1–2 were poor prognostic factors.

Conclusions

Patients with UAGC and a low CXI had poorer prognoses and more frequent grade 3–4 side effects, including FN, than those with a high CXI. Patients with UAGC and a low CXI should be carefully managed to control for side effects to receive subsequent treatment.
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Metadata
Title
Prognostic significance of the cachexia index in patients with unresectable advanced gastric cancer receiving palliative chemotherapy: a retrospective single-center study
Authors
Tomoyuki Matsunaga
Hiroaki Satio
Yu Sakano
Masahiro Makinoya
Shota Shimizu
Yuji Shishido
Kozo Miyatani
Takehiko Hanaki
Kyoichi Kihara
Manabu Yamamoto
Naruo Tokuyasu
Shuichi Takano
Teruhisa Sakamoto
Toshimichi Hasegawa
Yoshiyuki Fujiwara
Publication date
01-08-2023
Publisher
Springer Nature Singapore
Published in
Surgery Today / Issue 3/2024
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-023-02721-w

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