World Journal of Surgical Oncology | 2021
Impact of skeletal muscle mass in patients with recurrent gastric cancer
Abstract
Background We retrospectively examined the relationship among skeletal muscle mass index (SMI), prognosis, and chemotherapy side effects in patients with recurrent gastric cancer (RGC). Methods Sixty-seven patients who developed recurrence after undergoing curative gastrectomy for gastric cancer at Tottori University Hospital and received palliative chemotherapy were included in this study. Pretreatment computed tomography was performed to measure the skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra. We focused on haematologic toxicity (neutropenia, thrombocytopenia, and anaemia), febrile neutropenia, and gastrointestinal toxicity (diarrhoea, vomiting, and stomatitis) as the side effects of chemotherapy. Results Median SMIs for males and females (43.9 and 34.7\u2009cm 2 /m 2 , respectively) were used as cutoff values. The patients were classified into high (SMI High ; n = 34) and low SMI groups (SMI Low ; n = 33). The SMI Low group included more patients treated with monotherapy ( P = 0.016) compared with the SMI High group, had a significantly lower number of chemotherapy lines ( P = 0.049), and had a significantly higher incidence of grade 3 or 4 side effects ( P = 0.010). The median survival rate was significantly higher in the SMI High group (17.8 vs 15.8\u2009months; P = 0.034). In the univariate analysis, body mass index, SMI, histological type, and prognostic nutritional index were identified as prognostic indicators. The multivariate analysis identified SMI ( P = 0.037) and histological type ( P = 0.028) as independent prognostic factors. Conclusion The incidence of grade 3 or 4 side effects was significantly higher in patients with SMI Low RGC. SMI was a useful prognostic marker of RGC.