J Cancer 2019; 10(11):2450-2456. doi:10.7150/jca.30697

Research Paper

The postoperative lean body mass loss at one month leads to a poor survival in patients with locally advanced gastric cancer

Toru Aoyama1,2✉, Takaki Yoshikawa1,2, Yukio Maezawa1,2, Kazuki Kano1,2, Masakatsu Numata1,2, Kentaro Hara1,2, Keisuke Komori1,2, Takanobu Yamada1,2, Tsutomu Hayashi1,2, Tsutomu Sato1,2, Hiroshi Tamagawa1,2, Norio Yukawa2, Yasushi Rino2, Munetaka Masuda2, Takashi Ogata1, Haruhiko Cho1, Takashi Oshima1,2

1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
2. Department of Surgery, Yokohama City University, Yokohama, Japan

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Citation:
Aoyama T, Yoshikawa T, Maezawa Y, Kano K, Numata M, Hara K, Komori K, Yamada T, Hayashi T, Sato T, Tamagawa H, Yukawa N, Rino Y, Masuda M, Ogata T, Cho H, Oshima T. The postoperative lean body mass loss at one month leads to a poor survival in patients with locally advanced gastric cancer. J Cancer 2019; 10(11):2450-2456. doi:10.7150/jca.30697. Available from http://www.jcancer.org/v10p2450.htm

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Abstract

Aims: We previously demonstrated that a loss of lean body mass loss at one month after gastrectomy was an independent risk factor for the continuation of adjuvant chemotherapy with S-1. However, it is unclear whether or not lean body mass loss after gastrectomy leads to a poor survival through poor compliance to adjuvant chemotherapy with S-1.

Methods: The recurrence free survival (RFS) overall survival (OS) and were examined in 115 patients who underwent curative gastrectomy and were pathologically diagnosed with stage II or III gastric cancer and who received postoperative adjuvant chemotherapy with S-1 between May 2011 and September 2016.

Results: The median follow-up period was 40.6 months. The RFS rates at 5 years after surgery were 57.8% in the lean body mass loss ≥5% group and 73.5% in the lean body mass loss <5% group. The univariate and multivariate analyses for the disease free survival (RFS) demonstrated that a lean body mass loss >5% was a significant risk factor. The OS rates at 5 years after surgery were 72.0% in the lean body mass loss ≥5% group and 77.3% in the lean body mass loss <5% group. The OS was slightly worse in the lean body mass loss ≥5% group than in the lean body mass loss <5% group (p=0.2062).

Conclusions: The lean body mass loss at one month, which is closely associated with poor S-1 compliance, was an important risk factor for the RFS. A prospective cohort study is necessary to confirm whether or not the lean body mass loss affects the gastric cancer survival.

Keywords: gastric cancer - adjuvant chemotherapy- lean body mass loss -recurrence free survival