TY  - JOUR
A1  - Koch, Christine
A1  - Reitz, Cornelius-Emanuel Thomas
A1  - Schreckenbach, Teresa
A1  - Eichler, Katrin
A1  - Filmann, Natalie
A1  - Batran, Salah-Eddin al-
A1  - Götze, Thorsten
A1  - Zeuzem, Stefan
A1  - Bechstein, Wolf Otto
A1  - Kraus, Thomas
A1  - Bojunga, Jörg
A1  - Düx, Markus
A1  - Trojan, Jörg
A1  - Blumenstein, Irina Ursula
T1  - Sarcopenia as a prognostic factor for survival in patients with locally advanced gastroesophageal adenocarcinoma
T2  - PLoS one
N2  - Background and aims: Patients with gastric cancer often show signs of malnutrition. We sought to evaluate the influence of sarcopenia in patients with locally advanced, not metastasized, gastric or gastro-esophageal junction (GEJ) cancer undergoing curative treatment (perioperative chemotherapy and surgery) on morbidity and mortality in order to identify patients in need for nutritional intervention.
Patients and methods: Two-centre study, conducted in the Frankfurt University Clinic and Krankenhaus Nordwest (Frankfurt) as part of the University Cancer Center Frankfurt (UCT). 47/83 patients were treated in the FLOT trial (NCT01216644). Patients´ charts were reviewed for clinical data. Two consecutive CT scans were retrospectively analyzed to determine the degree of sarcopenia. Survival was calculated using the Kaplan-Meier method, multivariate analysis was performed using the Cox regression.
Results: 60 patients (72.3%) were male and 23 (27.7%) female. 45 patients (54.2%) had GEJ type 1–3 and 38 (45.8%) gastric tumors, respectively. Sarcopenic patients were significantly older than non-sarcopenic patients (mean age 65.1 years vs. 59.5 years, p = 0.042), terminated the chemotherapy significantly earlier (50% vs. 22.6%, p = 0.037) and showed higher Clavien-Dindo scores, indicating more severe perioperative complications (score ≥3 43.3 vs. 17.0%, p = 0.019). Sarcopenic patients had a significantly shorter survival than non-sarcopenic patients (139.6 ± 19.5 [95% CI, 101.3–177.9] vs. 206.7 ± 13.8 [95% CI, 179.5–233.8] weeks, p = 0.004). Multivariate Cox regression analysis showed that, besides UICC stage, sarcopenia significantly influenced survival.
Conclusion: Sarcopenia is present in a large proportion of patients with locally advanced gastric or GEJ cancer and significantly influences tolerability of chemotherapy, surgical complications and survival.
KW  - Sarcopenia
KW  - Cancer treatment
KW  - Cancer chemotherapy
KW  - Surgical and invasive medical procedures
KW  - Gastric cancer
KW  - Surgical oncology
KW  - Digestive system procedures
KW  - Regression analysis
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/51393
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-513934
SN  - 1932-6203
N1  - Copyright: © 2019 Koch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 14
IS  - (10): e0223613
SP  - 1
EP  - 11
PB  - PLoS
CY  - Lawrence, Kan.
ER  -