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. 2024 Jun 29;16(13):2408.
doi: 10.3390/cancers16132408.

Impact of Neoadjuvant Treatment on Body Composition in Patients with Locally Advanced Gastric Cancer

Luz Divina Juez  1   2   3 , Pablo Priego  4 , Marta Cuadrado  1   2 , Luis A Blázquez  1   2   3 , Silvia Sánchez-Picot  1 , Pablo Gil  1   3 , Federico Longo  2   5 , Julio Galindo  1   2   3 , José María Fernández-Cebrián  1   2   3 , José I Botella-Carretero  2   3   6
Affiliations

Impact of Neoadjuvant Treatment on Body Composition in Patients with Locally Advanced Gastric Cancer

Luz Divina Juez et al. Cancers (Basel). .

Abstract

Neoadjuvant chemotherapy (NT) followed by radical surgery is the standard treatment for locally advanced gastric cancer (GC). The incidence of sarcopenia in upper gastrointestinal tract malignancies is very high, and it may be increased after NT. This study aimed to evaluate the impact of NT on body composition. A retrospective study of patients with locally advanced GC undergoing gastrectomy who had received NT in a tertiary hospital between 2012 and 2019 was conducted. CT measured the skeletal muscle index, total psoas area, and visceral and subcutaneous adipose tissue before and after NT. Of the 180 gastrectomies for GC, 61 patients received NT. During NT, changes in body composition were observed with a decrease in the skeletal muscle mass index (SMMI -2.5%; p < 0.001), and these changes were significantly greater in men (SMMI -10.55%). Before surgery, patients who received NT presented 15% more sarcopenia than those without NT (p = 0.048). In conclusion, patients with locally advanced gastric cancer who receive NT have significant changes in body composition during chemotherapy. These changes, which are at the expense of a loss of muscle mass, lead to an increased incidence of pre-surgical sarcopenia.

Keywords: cancer; gastrectomy; gastric; neoadjuvant; sarcopenia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study. NT: neoadjuvant chemotherapy; CT: computed tomography.
Figure 2
Figure 2
Variation in the diagnosis of sarcopenia before and after chemotherapy. NT: neoadjuvant chemotherapy.
Figure 3
Figure 3
Variation in body composition values in patients with neoadjuvant therapy by sex. VAT: visceral adipose tissue; SAT: subcutaneous adipose tissue; SMMI: skeletal muscle mass index; PsoasI: Psoas Index; NT: neoadjuvant chemotherapy.
Figure 4
Figure 4
Waterfall plot chart of variation in SMMI in men after neoadjuvant treatment. Waterfall plot shows the difference between pre-neoadjuvant and post-neoadjuvant SMMI values in males (SMMI: SMMIneo cm2/m2). Each bar represents this difference in one patient. In 28 of the 34 males, this difference is negative with loss of muscle mass. SMMI: skeletal muscle mass index.
See this image and copyright information in PMC

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