Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
Identification of patients at risk for poor survival among those with normal skeletal muscle mass: a multicenter retrospective validation study in gastric cancer.
СтатьяМногоцентровое исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Matsui Ryota, Yamamoto Kazuyoshi, Yukawa Yoshiro, Terayama Masayoshi, Kurokawa Yukinori, Ichikawa Daisuke, Yanagimoto Yoshitomo, Oshima Takashi, Nunobe Souya, Kamei Takashi, Takeuchi Hiroya, Nabeya Yoshihiro, Kaibori Masaki, Hiki Naoki, Eguchi Hidetoshi, Doki Yuichiro
Аннотация
BACKGROUND: Although a low skeletal muscle mass index (SMI) leads to poor overall survival (OS) after gastrectomy in patients with gastric cancer, the cutoff value that predicts long-term survival in patients with normal SMI remains unclear. This study aimed to determine the cutoff SMI value for predicting OS in patients with normal SMI.
METHODS: This multicenter retrospective cohort study included patients with normal SMI who underwent radical gastrectomy for pStage I-III primary gastric cancer between January 2011 and December 2016. The patients were randomly divided at a 6:4 ratio into a training set, which examined the cutoff values for SMI, and a validation set, which validated the cutoff values. Patients were classified into high and low SMI groups according to the cutoff values. We compared OS between the high- and low-SMI groups using log-rank test and identified prognostic factors using Cox proportional hazards regression analysis.
RESULTS: Of the 2516 patients, 1389 (55.2%) and 1127 (44.8%) were classified into the training and validation sets. We examined the cutoff values of SMI, which were 44.3 cm2/m2 for men and 37.6 cm2/m2 for women. Both men and women in the low-SMI group had poorer OS than those in the high-SMI group. Multivariate analysis revealed that a low SMI was an independent adverse prognostic factor for OS (hazard ratio: 1.314, 95% confidence interval: 1.044-1.654, P = 0.020). These cutoff values were associated with lower cancer-specific survival.
CONCLUSIONS: Among patients with normal SMI, those with a lower SMI had poorer long-term survival after radical gastrectomy.
METHODS: This multicenter retrospective cohort study included patients with normal SMI who underwent radical gastrectomy for pStage I-III primary gastric cancer between January 2011 and December 2016. The patients were randomly divided at a 6:4 ratio into a training set, which examined the cutoff values for SMI, and a validation set, which validated the cutoff values. Patients were classified into high and low SMI groups according to the cutoff values. We compared OS between the high- and low-SMI groups using log-rank test and identified prognostic factors using Cox proportional hazards regression analysis.
RESULTS: Of the 2516 patients, 1389 (55.2%) and 1127 (44.8%) were classified into the training and validation sets. We examined the cutoff values of SMI, which were 44.3 cm2/m2 for men and 37.6 cm2/m2 for women. Both men and women in the low-SMI group had poorer OS than those in the high-SMI group. Multivariate analysis revealed that a low SMI was an independent adverse prognostic factor for OS (hazard ratio: 1.314, 95% confidence interval: 1.044-1.654, P = 0.020). These cutoff values were associated with lower cancer-specific survival.
CONCLUSIONS: Among patients with normal SMI, those with a lower SMI had poorer long-term survival after radical gastrectomy.