Low skeletal muscle density is associated with poor survival in patients who receive chemotherapy for metastatic gastric cancer

Hayashi,Naomi; Ando,Yuichi; Gyawali,Bishal; Shimokata,Tomoya; Maeda,Osamu; Fukaya,Masahide; Goto,Hidemi; Nagino,Masato; Kodera,Yasuhiro

doi:10.3892/or.2015.4475

Low skeletal muscle density is associated with poor survival in patients who receive chemotherapy for metastatic gastric cancer

Authors:
- Naomi Hayashi
- Yuichi Ando
- Bishal Gyawali
- Tomoya Shimokata
- Osamu Maeda
- Masahide Fukaya
- Hidemi Goto
- Masato Nagino
- Yasuhiro Kodera
View Affiliations

Affiliations: Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan, Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya 466-8550, Japan, Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
Published online on: December 8, 2015 https://doi.org/10.3892/or.2015.4475
Pages: 1727-1731

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Low skeletal muscle density (SMD) and low skeletal muscle index (SMI) are associated with poor overall survival (OS) in patients with various types of cancer. We retrospectively studied SMD and SMI using computed tomographic (CT) scans in patients with gastric cancer receiving chemotherapy to evaluate its prognostic significance. SMD and SMI were obtained from CT-based analysis using Slice-O-Matic® medical imaging software in patients who received S-1 plus cisplatin chemotherapy for metastatic gastric cancer. The CT images taken within 1 month before starting chemotherapy were used. The cut-off values for determining low SMD [<33 Hounsfield units (HU) in obese and <41 HU in non-obese patients] and low SMI (<41 cm2/m2 in females, <43 cm2/m2 in non-obese males and <53 cm2/m2 in obese males) were referenced from a large population based study. The CT images of 53 patients were reviewed. The median SMD was 36.8 HU (range, 19.5-59.3 HU), and the median SMI was 39.8 cm2/m2 (range, 23.7-60.0 cm2/m2). Patients with low SMD had significantly shorter OS compared with patients having normal SMD (8.9 vs. 12.8 months, P=0.03). However, OS did not differ significantly between patients with low and normal SMI (11.1 and 14.3 months, P=0.18). Multivariate analyses confirmed that low SMD was an independent predictor of poor outcomes (P<0.01). SMD is an important prognosticator of survival in patients with metastatic gastric cancer receiving chemotherapy.

View Figures

View References

1	Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L and Baracos VE: Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: A population-based study. Lancet Oncol. 9:629–635. 2008. View Article : Google Scholar : PubMed/NCBI
2	Peng P, Hyder O, Firoozmand A, Kneuertz P, Schulick RD, Huang D, Makary M, Hirose K, Edil B, Choti MA, et al: Impact of sarcopenia on outcomes following resection of pancreatic adenocarcinoma. J Gastrointest Surg. 16:1478–1486. 2012. View Article : Google Scholar : PubMed/NCBI
3	Harimoto N, Shirabe K, Yamashita YI, Ikegami T, Yoshizumi T, Soejima Y, Ikeda T, Maehara Y, Nishie A and Yamanaka T: Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. Br J Surg. 100:1523–1530. 2013. View Article : Google Scholar : PubMed/NCBI
4	van Vledder MG, Levolger S, Ayez N, Verhoef C, Tran TC and Ijzermans JN: Body composition and outcome in patients undergoing resection of colorectal liver metastases. Br J Surg. 99:550–557. 2012. View Article : Google Scholar : PubMed/NCBI
5	Lanic H, Kraut-Tauzia J, Modzelewski R, Clatot F, Mareschal S, Picquenot JM, Stamatoullas A, Leprêtre S, Tilly H and Jardin F: Sarcopenia is an independent prognostic factor in elderly patients with diffuse large B-cell lymphoma treated with immunochemotherapy. Leuk Lymphoma. 55:817–823. 2014. View Article : Google Scholar
6	Tan BH, Birdsell LA, Martin L, Baracos VE and Fearon KC: Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res. 15:6973–6979. 2009. View Article : Google Scholar : PubMed/NCBI
7	Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, Simonsick EM, Tylavsky FA, Visser M and Newman AB: The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 61:1059–1064. 2006. View Article : Google Scholar : PubMed/NCBI
8	Goodpaster BH, Kelley DE, Thaete FL, He J and Ross R: Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol (1985). 89:104–110. 2000.
9	Delmonico MJ, Harris TB, Visser M, Park SW, Conroy MB, Velasquez-Mieyer P, Boudreau R, Manini TM, Nevitt M, Newman AB, et al: Health, Aging, and Body: Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr. 90:1579–1585. 2009. View Article : Google Scholar : PubMed/NCBI
10	Martin L, Birdsell L, Macdonald N, Reiman T, Clandinin MT, McCargar LJ, Murphy R, Ghosh S, Sawyer MB and Baracos VE: Cancer cachexia in the age of obesity: Skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 31:1539–1547. 2013. View Article : Google Scholar : PubMed/NCBI
11	Antoun S, Lanoy E, Iacovelli R, Albiges-Sauvin L, Loriot Y, Merad-Taoufik M, Fizazi K, di Palma M, Baracos VE and Escudier B: Skeletal muscle density predicts prognosis in patients with metastatic renal cell carcinoma treated with targeted therapies. Cancer. 119:3377–3384. 2013. View Article : Google Scholar : PubMed/NCBI
12	Prado CM, Baracos VE, McCargar LJ, Reiman T, Mourtzakis M, Tonkin K, Mackey JR, Koski S, Pituskin E and Sawyer MB: Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 15:2920–2926. 2009. View Article : Google Scholar : PubMed/NCBI
13	Antoun S, Baracos VE, Birdsell L, Escudier B and Sawyer MB: Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann Oncol. 21:1594–1598. 2010. View Article : Google Scholar : PubMed/NCBI
14	Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, et al: S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): A phase III trial. Lancet Oncol. 9:215–221. 2008. View Article : Google Scholar : PubMed/NCBI
15	Mitsiopoulos N, Baumgartner RN, Heymsfield SB, Lyons W, Gallagher D and Ross R: Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol (1985). 85:115–122. 1998.
16	Yamaoka Y, Fujitani K, Tsujinaka T, Yamamoto K, Hirao M and Sekimoto M: Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy. Gastric Cancer. 18:382–389. 2015. View Article : Google Scholar
17	Abdiev S, Kodera Y, Fujiwara M, Koike M, Nakayama G, Ohashi N, Tanaka C, Sakamoto J and Nakao A: Nutritional recovery after open and laparoscopic gastrectomies. Gastric Cancer. 14:144–149. 2011. View Article : Google Scholar : PubMed/NCBI