Tadayoshi Hashimoto1, Yukinori Kurokawa2, Tsuyoshi Takahashi1, Takuro Saito1, Kotaro Yamashita1, Koji Tanaka1, Tomoki Makino1, Makoto Yamasaki1, Masaaki Motoori1,3, Yutaka Kimura1,4, Kiyokazu Nakajima1, Masaki Mori5, Yuichiro Doki1. 1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0871, Japan. 2. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0871, Japan. ykurokawa@gesurg.med.osaka-u.ac.jp. 3. Department of Surgery, Osaka General Medical Center, Osaka, Japan. 4. Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan. 5. Department of Surgery and Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Abstract
PURPOSE: Preoperative chemotherapy is an effective treatment option for resectable gastric cancer, but it is associated with various adverse events (AEs). This study aimed to identify the body composition parameters that most accurately predicted the incidence of AEs in preoperative chemotherapy for gastric cancer. METHODS: The present study included a total of 114 patients who received preoperative chemotherapy for resectable gastric cancer. We estimated various body composition parameters using computed tomography images obtained before preoperative chemotherapy. Their associations with the incidence of hematological (grade ≥ 3) and non-hematological (grade ≥ 2) AEs were analyzed by multivariate logistic regression analyses. RESULTS: Seventy-two of the 114 (63.2%) patients experienced hematological AEs (grade ≥ 3), specifically neutropenia in 68 (59.6%), anemia in 5 (4.9%), and thrombocytopenia in 3 (2.6%). Meanwhile, 59 patients (51.8%) experienced non-hematological AEs (grade ≥ 2), namely hypoalbuminemia in 31 (27.2%), anorexia in 24 (21.1%), and febrile neutropenia in 17 (14.9%). Multivariate analyses revealed that a low psoas muscle index (PMI) was an independent risk factor for the incidence of both hematological and non-hematological AEs. CONCLUSIONS: Patients with a low PMI experienced an increased incidence of hematological and non-hematological toxicities during preoperative chemotherapy for gastric cancer. Clinicians should be aware of these risks in this population.
PURPOSE: Preoperative chemotherapy is an effective treatment option for resectable gastric cancer, but it is associated with various adverse events (AEs). This study aimed to identify the body composition parameters that most accurately predicted the incidence of AEs in preoperative chemotherapy for gastric cancer. METHODS: The present study included a total of 114 patients who received preoperative chemotherapy for resectable gastric cancer. We estimated various body composition parameters using computed tomography images obtained before preoperative chemotherapy. Their associations with the incidence of hematological (grade ≥ 3) and non-hematological (grade ≥ 2) AEs were analyzed by multivariate logistic regression analyses. RESULTS: Seventy-two of the 114 (63.2%) patients experienced hematological AEs (grade ≥ 3), specifically neutropenia in 68 (59.6%), anemia in 5 (4.9%), and thrombocytopenia in 3 (2.6%). Meanwhile, 59 patients (51.8%) experienced non-hematological AEs (grade ≥ 2), namely hypoalbuminemia in 31 (27.2%), anorexia in 24 (21.1%), and febrile neutropenia in 17 (14.9%). Multivariate analyses revealed that a low psoas muscle index (PMI) was an independent risk factor for the incidence of both hematological and non-hematological AEs. CONCLUSIONS:Patients with a low PMI experienced an increased incidence of hematological and non-hematological toxicities during preoperative chemotherapy for gastric cancer. Clinicians should be aware of these risks in this population.
Entities:
Keywords:
Body composition parameters; Chemotherapeutic toxicity; Gastric cancer; Preoperative chemotherapy; Psoas muscle index
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