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Preoperative visceral fat index predicts the survival outcomes of patients with gastric cancer after surgery

机译:术前内脏脂肪指数预测胃癌患者术后生存结局

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摘要

Visceral adipose tissue and skeletal muscle mass are associated with carcinogenesis and clinical outcomes in patients with cancer. The aim of the present study was to determine the influence of body composition parameters on postoperative survival in patients with gastric cancer. Demographic data and systemic inflammatory response data were obtained from patients with gastric cancer undergoing radical gastrectomy. The patient's skeletal muscle and visceral fat were assessed using computed tomography, and the corresponding skeletal muscle index (SMI) and visceral fat index (VFI) were calculated. Univariate and multivariate analyses were then performed. Of the 342 patients from whom information was collected, 125 of these patients eventually succumbed to the disease. A total of 271 (79.24%) of the patients were male and 71 (20.76%) were female. Regarding the entire cohort, the mean age was 64 years [interquartile range (IQR), 56–74 years], while the mean body mass index collected was 21.53 (IQR, 19.27–24.22). The median SMI and VFI of the patients were 47.73 (IQR, 41.67–55.51) and 41.28 (IQR, 36.62–45.36), respectively. It was concluded that a low SMI and VFI were associated with worse survival outcomes. However, the neutrophil-to-lymphocyte ratio and perioperative blood transfusion were not significantly associated with overall survival (OS). Among the indicators assessed, a low VFI was an independent risk factor associated with the worst OS time (hazard ratio 1.59; confidence interval, 1.03–2.45; P=0.038). Finally, a prognostic nomogram was constructed which included the VFI to assist clinicians in making more informed decisions. In conclusion, after data collection and analysis, it was found that there was a significant correlation between a low VFI and a shorter OS time in patients with gastric cancer following gastrectomy, suggesting that VFI may be a promising therapeutic target for postoperative interventions to improve patient survival further.
机译:内脏脂肪组织和骨骼肌质量与癌症患者的致癌作用和临床结果有关。本研究的目的是确定身体成分参数对胃癌患者术后生存率的影响。人口统计学数据和全身炎症反应数据来自接受根治性胃切除术的胃癌患者。使用计算机断层扫描评估患者的骨骼肌和内脏脂肪,并计算相应的骨骼肌指数 (SMI) 和内脏脂肪指数 (VFI)。然后进行单变量和多变量分析。在收集信息的 342 名患者中,其中 125 名患者最终死于这种疾病。共有 271 名 (79.24%) 患者为男性,71 名 (20.76%) 为女性。关于整个队列,平均年龄为 64 岁 [四分位距 (IQR),56-74 岁],而收集的平均体重指数为 21.53 (IQR,19.27-24.22)。患者的中位 SMI 和 VFI 分别为 47.73 (IQR,41.67-55.51) 和 41.28 (IQR,36.62-45.36)。得出的结论是,低 SMI 和 VFI 与较差的生存结果相关。然而,中性粒细胞与淋巴细胞比值和围手术期输血与总生存期 (OS) 无显著相关性。在评估的指标中,低 VFI 是与最差 OS 时间相关的独立风险因素(风险比 1.59;置信区间,1.03-2.45;P=0.038)。最后,构建了包括 VFI 在内的预后列线图,以帮助临床医生做出更明智的决策。总之,经过数据收集和分析,发现胃切除术后胃癌患者的低 VFI 与较短的 OS 时间之间存在显着相关性,表明 VFI 可能是术后干预的有前途的治疗靶点,以进一步提高患者生存率。

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