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CT-derived skeletal muscle change before immunotherapy predicts survival of advanced gastric cancer: associations with inflammatory markers and liver lipid metabolism.
- Source :
-
International journal of clinical oncology [Int J Clin Oncol] 2024 Sep; Vol. 29 (9), pp. 1255-1262. Date of Electronic Publication: 2024 May 22. - Publication Year :
- 2024
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Abstract
- Background: Skeletal muscle (SM) is a key factor in cancer treatment. However, it is unclear whether pretreatment SM change affects the outcome of immune checkpoint inhibitors (ICIs) therapy in gastric cancer (GC).<br />Methods: Advanced GCs treated with ICIs were retrospectively investigated. SM evaluated by psoas muscle area at the third lumbar vertebra was measured on CT acquired within 1 month from the start of ICIs therapy (CT-1), and on CT acquired 2.8 ± 0.84 months before CT-1. Monthly change rate of SM (MCR-SM) was defined as the change rate of SMs between those two CTs divided by the period between those CTs (month). Monthly change rate of body weight (MCR-BW) during the same period was also calculated. They were compared with disease-specific survival (DSS) and progression-free survival (PFS). MCR-SM was compared with pretreatment markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein (CRP), and liver-to-spleen CT attenuation ratio (LSR) as a marker of liver lipid metabolism.<br />Results: This study enrolled eighty-three GC patients. MCR-SM significantly correlated with DSS and PFS (P < 0.0001, 0.001, respectively), whereas MCR-BW did not. Kaplan-Meier analyses demonstrated that higher MCR-SM (MCR-SM ≥ -0.7185%) significantly associated with better DSS and PFS (P = 0.0002, 0.03, respectively). Patients with positive MCR-SM showed significantly lower NLR, MLR, and CRP than those with negative (P = 0.01, 0.006, 0.003, respectively). MCR-SM showed a significant positive correlation with LSR (P = 0.007, R = 0.30).<br />Conclusions: Pretreatment SM loss, associated with high systemic inflammation and hepatic fat accumulation, related to poor outcome of ICIs therapy in GC.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Retrospective Studies
Muscle, Skeletal metabolism
Immune Checkpoint Inhibitors therapeutic use
Adult
Aged, 80 and over
Immunotherapy methods
Prognosis
Stomach Neoplasms pathology
Stomach Neoplasms mortality
Stomach Neoplasms metabolism
Tomography, X-Ray Computed
Lipid Metabolism
Liver metabolism
Liver pathology
Liver diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1437-7772
- Volume :
- 29
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- International journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38775896
- Full Text :
- https://doi.org/10.1007/s10147-024-02551-x