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Current Oncology
Volume 25
Issue 5
10.3747/co.25.4014
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Article

Computed Tomography–Quantified Body Composition Predicts Short-Term Outcomes After Gastrectomy in Gastric Cancer

by
Y. Zhang
1,2,
J.P. Wang
3,4,
X.L. Wang
1,*,
H. Tian
5,
T.T. Gao
1,
L.M. Tang
6,
F. Tian
1,
J.W. Wang
1,
H.J. Zheng
7,
L. Zhang
1,
X.J. Gao
1,
G.L. Li
1,* and
X.Y. Wang
1
1
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing 210002, China
2
Department of Cardiothoracic Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
3
Jinling Clinical Medical College of Nanjing Medical University, Nanjing, China
4
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
5
Department of General Surgery, Jinling Hospital Affiliated to Southern Medical University, Nanjing, China
6
Changzhou No. 2 People’s Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou School of Clinical Medicine of Nanjing Medical University, Changzhou, China
7
Intensive Care Unit, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, China
*
Authors to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(5), 411-422; https://doi.org/10.3747/co.25.4014
Submission received: 4 July 2018 / Revised: 5 August 2018 / Accepted: 6 September 2018 / Published: 1 October 2018

Abstract

Background: Malnutrition is a common and critical problem that influences outcome in cancer patients. Body composition reflects a patient’s metabolic profile and physiologic reserves, which might be the true determinant of prognosis. In the present study, which aimed to identify valuable new prognostic indicators, we investigated the association between computed tomography–quantified body composition and short-term outcomes after gastrectomy for gastric cancer. Methods: Skeletal muscle index, mean muscle attenuation, and ratio of visceral-to-subcutaneous adipose tissue area (VSR) were calculated from preoperative computed tomography images. Low skeletal muscle index, low mean muscle attenuation, and high VSR were respectively termed “sarcopenia,” “myosteatosis,” and “visceral obesity.” The association of body composition with postoperative complications and serum markers of nutrition and inflammation after radical gastrectomy were analyzed. Results: The overall complication rate was significantly higher in the sarcopenia (62.5% vs. 27.3%, p = 0.001) and myosteatosis groups (38.2% vs. 4%, p = 0.002). Patients with visceral obesity had a higher incidence of inflammatory complications (20.3% vs. 6.5%, p = 0.01). Multivariate logistic regression analysis demonstrated that sarcopenia (p = 0.013), myosteatosis (p = 0.017), and low serum retinol-binding protein (p = 0.019) were independent risk factors for overall complications. Compared with control subjects, patients with sarcopenia had lower postoperative levels of serum retinol-binding protein (p = 0.007), and patients with visceral obesity had higher levels of C-reactive protein (p = 0.026). Conclusions: Sarcopenia, myosteatosis, and visceral obesity were significantly associated with increased rates of postoperative complications and affected the postoperative nutrition and inflammation status of patients with gastric cancer.
Keywords: body composition; sarcopenia; myosteatosis; visceral obesity; gastrectomy; complications body composition; sarcopenia; myosteatosis; visceral obesity; gastrectomy; complications

Share and Cite

MDPI and ACS Style

Zhang, Y.; Wang, J.P.; Wang, X.L.; Tian, H.; Gao, T.T.; Tang, L.M.; Tian, F.; Wang, J.W.; Zheng, H.J.; Zhang, L.; et al. Computed Tomography–Quantified Body Composition Predicts Short-Term Outcomes After Gastrectomy in Gastric Cancer. Curr. Oncol. 2018, 25, 411-422. https://doi.org/10.3747/co.25.4014

AMA Style

Zhang Y, Wang JP, Wang XL, Tian H, Gao TT, Tang LM, Tian F, Wang JW, Zheng HJ, Zhang L, et al. Computed Tomography–Quantified Body Composition Predicts Short-Term Outcomes After Gastrectomy in Gastric Cancer. Current Oncology. 2018; 25(5):411-422. https://doi.org/10.3747/co.25.4014

Chicago/Turabian Style

Zhang, Y., J.P. Wang, X.L. Wang, H. Tian, T.T. Gao, L.M. Tang, F. Tian, J.W. Wang, H.J. Zheng, L. Zhang, and et al. 2018. "Computed Tomography–Quantified Body Composition Predicts Short-Term Outcomes After Gastrectomy in Gastric Cancer" Current Oncology 25, no. 5: 411-422. https://doi.org/10.3747/co.25.4014

APA Style

Zhang, Y., Wang, J. P., Wang, X. L., Tian, H., Gao, T. T., Tang, L. M., Tian, F., Wang, J. W., Zheng, H. J., Zhang, L., Gao, X. J., Li, G. L., & Wang, X. Y. (2018). Computed Tomography–Quantified Body Composition Predicts Short-Term Outcomes After Gastrectomy in Gastric Cancer. Current Oncology, 25(5), 411-422. https://doi.org/10.3747/co.25.4014

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