CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study
Aim. Computed tomographic preoperative assessment of sarcopenia in patients with gastric cancer as a part of combined treatment and the study of the relationship between sarcopenia and postoperative complications. Materials and methods. We analyzed retrospectively the data of 65 patients with mor...
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| Format: | Article |
| Language: | Russian |
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IP Habib O.N.
2023-12-01
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| Series: | Современная онкология |
| Subjects: | |
| Online Access: | https://modernonco.orscience.ru/1815-1434/article/viewFile/401015/pdf |
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| author | Tatev A. Agababyan Valeria A. Kukarskaya Natalya K. Silanteva Aleksandr L. Potapov Vitaliy Yu. Skoropad Elisaveta V. Sheberova Artem D. Dorozhkin Sergey А. Ivanov Andrey D. Kaprin |
| author_facet | Tatev A. Agababyan Valeria A. Kukarskaya Natalya K. Silanteva Aleksandr L. Potapov Vitaliy Yu. Skoropad Elisaveta V. Sheberova Artem D. Dorozhkin Sergey А. Ivanov Andrey D. Kaprin |
| author_sort | Tatev A. Agababyan |
| collection | DOAJ |
| description | Aim. Computed tomographic preoperative assessment of sarcopenia in patients with gastric cancer as a part of combined treatment and the study of the relationship between sarcopenia and postoperative complications.
Materials and methods. We analyzed retrospectively the data of 65 patients with morphologically verified diagnosis of stage IIA–IIIC gastric cancer. All patients at stage I of the combined treatment received neoadjuvant chemotherapy (NCT) according to the FLOT regimen, and then a gastrectomy with D2 lymph node dissection was performed. Computed tomography (CT) scans were performed before NCT initiation and 3.5 to 5 weeks after NCT completion for preoperative staging and assessment of tumor response. Using the obtained CT data, CT sarcometry was performed by calculating the cross-sectional area of skeletal muscles at the LIII vertebra level and the “skeletal-muscular index”. Postoperative complications were assessed using the Clavien–Dindo classification. Non-parametric comparison methods were used to assess the significance of differences between groups and subgroups (Wilcoxon T-test, Pearson χ2 test). Differences were considered statistically significant at p0.05.
Results. We analyzed the incidence of sarcopenia in the examined patients before the NCT and immediately before the surgery. Sarcopenia was noted in 41 (63.1%) of 65 patients before NCT and in 50 (76.9%) patients after NCT, which indicates its high prevalence in patients with stomach cancer and the adverse effect of NCT on the muscular status of patients (76.9% versus 63.1%). Postoperative complications were diagnosed in 12 of 65 patients (18.5%). The rate of postoperative complications in patients with and without sarcopenia was not statistically significantly different (p=0.392); however, complications of Clavien–Dindo grade ≥IIIb occurred only in patients with sarcopenia (p0.001).
Conclusion. According to our data, NCT in gastric cancer aggravates preoperative nutritional disorders. CT, as a standard method of staging and assessing the tumor response to NCT for gastric cancer, provides a tool to assess the state of muscle mass in patients before and after NCT. Preoperative sarcopenia is a risk factor for severe postoperative complications in patients with gastric cancer after gastrectomy. |
| first_indexed | 2024-03-08T22:28:36Z |
| format | Article |
| id | doaj.art-b0c07e16491b4eeda353d69d0c2890de |
| institution | Directory Open Access Journal |
| issn | 1815-1434 1815-1442 |
| language | Russian |
| last_indexed | 2024-03-08T22:28:36Z |
| publishDate | 2023-12-01 |
| publisher | IP Habib O.N. |
| record_format | Article |
| series | Современная онкология |
| spelling | doaj.art-b0c07e16491b4eeda353d69d0c2890de2023-12-18T08:35:20ZrusIP Habib O.N.Современная онкология1815-14341815-14422023-12-0125328428810.26442/18151434.2023.3.20226079506CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort studyTatev A. Agababyan0https://orcid.org/0000-0002-9971-3451Valeria A. Kukarskaya1Natalya K. Silanteva2Aleksandr L. Potapov3https://orcid.org/0000-0003-3752-3107Vitaliy Yu. Skoropad4Elisaveta V. Sheberova5Artem D. Dorozhkin6https://orcid.org/0000-0001-9565-301XSergey А. Ivanov7https://orcid.org/0000-0001-7689-6032Andrey D. Kaprin8https://orcid.org/0000-0001-8784-8415Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentreTsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological CentrePeople’s Friendship University of Russia (RUDN University)Aim. Computed tomographic preoperative assessment of sarcopenia in patients with gastric cancer as a part of combined treatment and the study of the relationship between sarcopenia and postoperative complications. Materials and methods. We analyzed retrospectively the data of 65 patients with morphologically verified diagnosis of stage IIA–IIIC gastric cancer. All patients at stage I of the combined treatment received neoadjuvant chemotherapy (NCT) according to the FLOT regimen, and then a gastrectomy with D2 lymph node dissection was performed. Computed tomography (CT) scans were performed before NCT initiation and 3.5 to 5 weeks after NCT completion for preoperative staging and assessment of tumor response. Using the obtained CT data, CT sarcometry was performed by calculating the cross-sectional area of skeletal muscles at the LIII vertebra level and the “skeletal-muscular index”. Postoperative complications were assessed using the Clavien–Dindo classification. Non-parametric comparison methods were used to assess the significance of differences between groups and subgroups (Wilcoxon T-test, Pearson χ2 test). Differences were considered statistically significant at p0.05. Results. We analyzed the incidence of sarcopenia in the examined patients before the NCT and immediately before the surgery. Sarcopenia was noted in 41 (63.1%) of 65 patients before NCT and in 50 (76.9%) patients after NCT, which indicates its high prevalence in patients with stomach cancer and the adverse effect of NCT on the muscular status of patients (76.9% versus 63.1%). Postoperative complications were diagnosed in 12 of 65 patients (18.5%). The rate of postoperative complications in patients with and without sarcopenia was not statistically significantly different (p=0.392); however, complications of Clavien–Dindo grade ≥IIIb occurred only in patients with sarcopenia (p0.001). Conclusion. According to our data, NCT in gastric cancer aggravates preoperative nutritional disorders. CT, as a standard method of staging and assessing the tumor response to NCT for gastric cancer, provides a tool to assess the state of muscle mass in patients before and after NCT. Preoperative sarcopenia is a risk factor for severe postoperative complications in patients with gastric cancer after gastrectomy.https://modernonco.orscience.ru/1815-1434/article/viewFile/401015/pdfcomputed tomographysarcopeniagastric cancerpostoperative complicationsneoadjuvant chemotherapy |
| spellingShingle | Tatev A. Agababyan Valeria A. Kukarskaya Natalya K. Silanteva Aleksandr L. Potapov Vitaliy Yu. Skoropad Elisaveta V. Sheberova Artem D. Dorozhkin Sergey А. Ivanov Andrey D. Kaprin CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study Современная онкология computed tomography sarcopenia gastric cancer postoperative complications neoadjuvant chemotherapy |
| title | CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study |
| title_full | CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study |
| title_fullStr | CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study |
| title_full_unstemmed | CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study |
| title_short | CT sarcometry in the prediction of postoperative complications in patients with gastric cancer: Retrospective cohort study |
| title_sort | ct sarcometry in the prediction of postoperative complications in patients with gastric cancer retrospective cohort study |
| topic | computed tomography sarcopenia gastric cancer postoperative complications neoadjuvant chemotherapy |
| url | https://modernonco.orscience.ru/1815-1434/article/viewFile/401015/pdf |
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