Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study

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Lascala, Fabiana ; da Silva Moraes, Bruna Karoline ; Santos Mendes, Maria Carolina ; de Carvalho, Mariluce Barbosa ; Branbilla, Sandra Regina ; da Cunha Junior, Ademar Dantas ; Lopes, Luiz Roberto ; Andreollo, Nelson Adami ; Macedo, Ligia Traldi ; Prado, Carla M. ; Campello Carvalheira, Jose Barreto

• Tipo de documento: Artigo Científico
• Fonte: European Journal of Clinical Nutrition; v. 77, n. 1, p. 11-pg., 2022-09-08.

Resumo

BACKGROUND/OBJECTIVES: The association between systemic inflammation and myosteatosis upon diagnosis of gastric cancer (GC) and whether these factors could predict survival outcomes is not clear. Our aim was to explore the association between systemic inflammation and myosteatosis upon diagnosis of GC, specially whether the co-occurrence of these factors could predict survival outcomes. SUBJECTS/METHODS: Computed tomography (CT) was performed at the level of the third lumbar vertebra for body composition analysis in 280 patients with GC. Myoesteatosis was defined as the lowest tertile of the muscle radiodensity distribution or based on clinical significance using optimal stratification analysis. Inflammatory indexes were measured, including the neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte and lymphocyte-to-monocyte ratios. RESULTS: Patients with low skeletal muscle (SM) radiodensity were more likely to be older than 65 years, have a higher body mass index and have diabetes. They also had higher intermuscular visceral and subcutaneous adipose tissue areas and indexes. The highest tertile of SM radiodensity was associated with better disease-free survival (DFS) (HR = 0.51, 95% CI [0.31, 0.84], p(trend) = 0.020) and overall survival (OS) (HR = 0.49, 95% CI [0.29, 0.82], p(trend) = 0.022). Patients with NLR > 2.3 and myosteatosis had the worst DFS and OS (HR = 2.77, 95% CI [1.54, 5.00], p = 0.001; HR = 3.31, 95% CI [1.79, 6.15], p < 0.001, respectively). CONCLUSION: Co-occurrence of myosteatosis and inflammation increased disease progression and death risk by almost three times. These regularly obtained biomarkers might improve prognostic risk prediction in resectable GC. (AU)

• Processo FAPESP: 18/23428-0 - Caracterização do perfil metabólico de pacientes com câncer colorretal que diferem quanto à sarcopenia
• Beneficiário: José Barreto Campello Carvalheira
• Modalidade de apoio: Auxílio à Pesquisa - Regular