Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil

Abstract Background The mortality rate of patients with unresectable gastric cancer (UGC) has decreased with the development of chemotherapies and surgical techniques. However, the survival rate remains low. We retrospectively examined the prognostic significance of the pretreatment skeletal muscle...

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Autores principales:	Tomoyuki Matsunaga, Hiroaki Saito, Wataru Miyauchi, Yuji Shishido, Kozo Miyatani, Masaki Morimoto, Yuki Murakami, Takehiko Hanaki, Kyoichi Kihara, Manabu Yamamoto, Naruo Tokuyasu, Shuichi Takano, Teruhisa Sakamoto, Toshimichi Hasegawa, Yoshiyuki Fujiwara
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Gastric cancer Chemotherapy Skeletal muscle mass Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/d5f31f73e8c8488ab30183c4d39ffee6
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spelling	oai:doaj.org-article:d5f31f73e8c8488ab30183c4d39ffee62021-11-14T12:29:53ZImpact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil10.1186/s12885-021-08953-81471-2407https://doaj.org/article/d5f31f73e8c8488ab30183c4d39ffee62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12885-021-08953-8https://doaj.org/toc/1471-2407Abstract Background The mortality rate of patients with unresectable gastric cancer (UGC) has decreased with the development of chemotherapies and surgical techniques. However, the survival rate remains low. We retrospectively examined the prognostic significance of the pretreatment skeletal muscle mass index (SMI) and nutritional and inflammatory factors in patients with UGC. Methods This study included 83 patients diagnosed with UGC at Tottori University Hospital who received palliative chemotherapy based on 5-fluorouracil. Pretreatment computed tomography (CT) measured overall skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra (L3). We focused on the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein-to-albumin ratio (CAR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) as nutritional and inflammatory factors. Results Receiver operating characteristic curve analysis was performed for median survival time (MST) after palliative chemotherapy. SMIs for males and females (43.9 cm2/m2 and 34.7 cm2/m2, respectively) were the cutoff values, and patients were divided into high (SMIHigh; n = 41) and low SMI groups (SMILow; n = 42). Body mass index (BMI) was significantly higher in patients in the SMIHigh group than in the SMILow group (p < 0.001). The number of patients who received third-line chemotherapy was significantly higher in the SMIHigh group than in the SMILow group (p = 0.037). The MST was significantly higher in the SMIHigh group than in the SMILow group (17.3 vs. 13.8 months; p = 0.008). The incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow UGC (p = 0.028). NLR was significantly higher in patients with SMILow than it was in those with SMIHigh. (p = 0.047). In the univariate analysis, performance status, SMI, histological type, lines of chemotherapy, and NLR were prognostic indicators. The multivariate analysis identified SMI (p = 0.037), NLR (p = 0.002), and lines of chemotherapy (p < 0.001) as independent prognostic factors. Conclusions The SMILow group had significantly more grade 3 or 4 side effects, were related to high NLR, and had a significantly worse prognosis than the SMIHigh group. Trial registration Retrospectively registerd.Tomoyuki MatsunagaHiroaki SaitoWataru MiyauchiYuji ShishidoKozo MiyataniMasaki MorimotoYuki MurakamiTakehiko HanakiKyoichi KiharaManabu YamamotoNaruo TokuyasuShuichi TakanoTeruhisa SakamotoToshimichi HasegawaYoshiyuki FujiwaraBMCarticleGastric cancerChemotherapySkeletal muscle massNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gastric cancer Chemotherapy Skeletal muscle mass Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Gastric cancer Chemotherapy Skeletal muscle mass Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Tomoyuki Matsunaga Hiroaki Saito Wataru Miyauchi Yuji Shishido Kozo Miyatani Masaki Morimoto Yuki Murakami Takehiko Hanaki Kyoichi Kihara Manabu Yamamoto Naruo Tokuyasu Shuichi Takano Teruhisa Sakamoto Toshimichi Hasegawa Yoshiyuki Fujiwara Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
description	Abstract Background The mortality rate of patients with unresectable gastric cancer (UGC) has decreased with the development of chemotherapies and surgical techniques. However, the survival rate remains low. We retrospectively examined the prognostic significance of the pretreatment skeletal muscle mass index (SMI) and nutritional and inflammatory factors in patients with UGC. Methods This study included 83 patients diagnosed with UGC at Tottori University Hospital who received palliative chemotherapy based on 5-fluorouracil. Pretreatment computed tomography (CT) measured overall skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra (L3). We focused on the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein-to-albumin ratio (CAR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) as nutritional and inflammatory factors. Results Receiver operating characteristic curve analysis was performed for median survival time (MST) after palliative chemotherapy. SMIs for males and females (43.9 cm2/m2 and 34.7 cm2/m2, respectively) were the cutoff values, and patients were divided into high (SMIHigh; n = 41) and low SMI groups (SMILow; n = 42). Body mass index (BMI) was significantly higher in patients in the SMIHigh group than in the SMILow group (p < 0.001). The number of patients who received third-line chemotherapy was significantly higher in the SMIHigh group than in the SMILow group (p = 0.037). The MST was significantly higher in the SMIHigh group than in the SMILow group (17.3 vs. 13.8 months; p = 0.008). The incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow UGC (p = 0.028). NLR was significantly higher in patients with SMILow than it was in those with SMIHigh. (p = 0.047). In the univariate analysis, performance status, SMI, histological type, lines of chemotherapy, and NLR were prognostic indicators. The multivariate analysis identified SMI (p = 0.037), NLR (p = 0.002), and lines of chemotherapy (p < 0.001) as independent prognostic factors. Conclusions The SMILow group had significantly more grade 3 or 4 side effects, were related to high NLR, and had a significantly worse prognosis than the SMIHigh group. Trial registration Retrospectively registerd.
format	article
author	Tomoyuki Matsunaga Hiroaki Saito Wataru Miyauchi Yuji Shishido Kozo Miyatani Masaki Morimoto Yuki Murakami Takehiko Hanaki Kyoichi Kihara Manabu Yamamoto Naruo Tokuyasu Shuichi Takano Teruhisa Sakamoto Toshimichi Hasegawa Yoshiyuki Fujiwara
author_facet	Tomoyuki Matsunaga Hiroaki Saito Wataru Miyauchi Yuji Shishido Kozo Miyatani Masaki Morimoto Yuki Murakami Takehiko Hanaki Kyoichi Kihara Manabu Yamamoto Naruo Tokuyasu Shuichi Takano Teruhisa Sakamoto Toshimichi Hasegawa Yoshiyuki Fujiwara
author_sort	Tomoyuki Matsunaga
title	Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
title_short	Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
title_full	Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
title_fullStr	Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
title_full_unstemmed	Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
title_sort	impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d5f31f73e8c8488ab30183c4d39ffee6
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Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil

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