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>Clinical Significance of Paraspinal Muscle Parameters as a prognostic factor for survival in Gastric Cancer Patients who underwent Curative Surgical Resection
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Clinical Significance of Paraspinal Muscle Parameters as a prognostic factor for survival in Gastric Cancer Patients who underwent Curative Surgical Resection
Background: The quantitative and qualitative skeletal muscle parameters have been proposed to predict the outcome of patients with gastric cancer. However, the evidence for their association with long-term survival is still conflicting. This study aimed to investigate the effect of paraspinal muscle parameters on overall survival (OS) and disease-free survival (DFS) in patients with gastric cancer who underwent curative resection. Methods: Patients with stages I or II gastric cancer who underwent curative resection between October 2006 and June 2016 were identified from electrical medical records. Paraspinal muscle area and attenuation were measured at the level of the third lumbar vertebra using computerized tomography images. For the analysis of OS and DFS, proportional hazards model was used, incorporating demographic, pathologic, laboratory, and radiologic variables. Results: This study enrolled 296 patients (192 men and 104 women). In the multivariate proportional hazards model, total gastrectomy (hazard ratio [HR], 2.65; 95% Confidence interval [CI], 1.36-5.19; p = 0.0044), neutrophil-lymphocyte ratio (NLR) (HR, 1.27; 95% CI, 1.06-1.51; p = 0.0081), serum albumin level (HR, 0.16; 95% CI, 0.07-0.39; p 0.0001), paraspinal muscle area adjusted for body surface area (PMA BSA ) (HR, 3.06; 95% CI, 1.65-5.67; p = 0.0004), and mean attenuation in paraspinal muscle (PMMA) (HR, 3.38; 95% CI, 1.75-6.53; p = 0.0003) were prognostic factors for OS. Similarly, total gastrectomy (HR, 2.11; 95% CI, 1.10-4.06; p = 0.0243), NLR (HR, 1.25; 95% CI, 1.06-1.48; p = 0.0071), serum albumin level (HR, 0.22; 95% CI, 0.10-0.51; p = 0.0035), PMA BSA (HR, 2.42; 95% CI, 1.34-4.37; p = 0.0035), and PMMA (HR, 3.19; 95% CI, 1.71-5.93; p = 0.0003) were prognostic factors for DFS. Conclusions: The pretreatment paraspinal muscle parameters such as PMA BSA and PMMA along with total gastrectomy, NLR, and serum albumin level could predict OS and DFS in patients with stages I or II gastric cancer who underwent curative surgical resection. Because PMA BSA and PMMA are newly characterized parameters in gastric cancer, the relationship with the survival of these parameters requires further validation in further studies before they are subjected to clinical applications.? The author(s).
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机译：背景：已经提出了定量和定性骨骼肌参数来预测胃癌患者的结果。但是，与长期生存期的股权仍然相互矛盾。本研究旨在探讨患有治疗切除治疗患者患者总生存（OS）和无病生存（DFS）的肩胛骨肌肉参数的影响。方法：从电气医疗记录中确定了2006年10月和2016年6月期间接受治疗切除疗效的阶段I或II胃癌的患者。使用计算机断层扫描图像在第三腰椎的水平下测量椎间肌区域和衰减。为了分析OS和DFS，使用比例危险模型，包括人口统计学，病理，实验室和放射学变量。结果：本研究注册了296名患者（192名男子和104名妇女）。在多变量比例危险模型中，总胃切除术（危害比[HR]，2.65; 95％置信区间[CI]，1.36-5.19; P = 0.0044），中性粒细胞淋巴细胞比（NLR）（HR，1.27; 95％CI ，1.06-1.51; p = 0.0081），血清白蛋白水平（HR，0.16; 95％CI，0.07-0.39; p <0.0001），适用于体表面积（PMA BSA）（HR，3.06; 95％）调节的椎间围肌面积CI，1.65-5.67; p = 0.0004），垂直肌肉（PMMA）的平均衰减（HR，3.38; 95％CI，1.75-6.53; p = 0.0003）是OS的预后因素。同样地，总胃切除术（HR，2.11; 95％CI，1.10-4.06; P = 0.0243），NLR（HR，1.25; 95％CI，1.06-1.48; P = 0.0071），血清白蛋白水平（HR，0.22; 95 ％CI，0.10-0.51; p = 0.0035），PMA BSA（HR，2.42; 95％CI，1.34-4.37; P = 0.0035）和PMMA（HR，3.19; 95％CI，1.71- 5.93; P = 0.0003 ）是DFS的预后因素。结论：PMA BSA和PMMA等预处理椎间形肌肉参数以及总胃切除术，NLR和血清白蛋白水平可以预测患有疗法手术切除症的患者I或II胃癌的OS和DFS。因为PMA BSA和PMMA是胃癌中的新表征参数，所以与这些参数的存活关系的关系需要在进行临床应用之前进一步的研究进一步验证。作者。
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