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, 9 (10), 844-859

Validation of Skeletal Muscle Volume as a Nutritional Assessment in Patients With Gastric or Colorectal Cancer Before Radical Surgery

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Validation of Skeletal Muscle Volume as a Nutritional Assessment in Patients With Gastric or Colorectal Cancer Before Radical Surgery

Takayuki Endo et al. J Clin Med Res.

Erratum in

Abstract

Background: Recently, some studies have reported the importance of sarcopenia as a prognostic factor in patients with gastrointestinal cancer who have undergone surgery. We aimed to examine skeletal muscle volume for use in nutritional assessment of preoperative patients, and to compare the results with those of other conventional methods of nutritional assessment, such as biochemical or body composition values.

Methods: This was an open cohort study which examined skeletal muscle volume for use in nutritional assessment of preoperative patients. A total of 121 patients with gastrointestinal cancer who underwent radical surgery were enrolled in this study between June 1, 2008 and December 31, 2012. There were 39 and 82 patients with gastric and colorectal cancer, respectively. The primary outcome of this study was postoperative overall survival. The secondary outcomes were postoperative survival from cancer-related deaths, recurrences of cancer after surgery, postoperative complications, and postoperative hospital inpatient stay (measured in days). Univariate and multivariate analyses were used to identify the relevant factors for postoperative outcomes mentioned above.

Results: Skeletal muscle volume was a significant (hazard ratio (HR): 3.34, 95% confidence interval (CI): 1.21 - 9.17, P = 0.020) independent prognostic factor for cancer-related deaths in patients with gastric or colorectal cancer who had undergone surgery, and a marginally independent (HR: 2.48, 95% CI: 0.91 - 6.81, P = 0.077) factor that negatively contributed to overall survival in these patients. In contrast, the preoperative skeletal muscle volume was not correlated with the recurrence of cancer, and was not significantly correlated with the occurrence of severe complications after surgery or prolongation of hospitalization.

Conclusions: The preoperative skeletal muscle volume was a significant prognostic factor in patients with gastric or colorectal cancers. Therefore, the estimation of skeletal muscle volume may be important for stable, long-term nutritional assessment in patients with gastrointestinal cancers.

Keywords: Colorectal cancer; Gastric cancer; Preoperative nutritional assessment; Prognostic factor; Sarcopenia; Skeletal muscle volume.

Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Flow diagram according to selection and exclusion criteria.
Figure 2
Figure 2
The differences in cumulative overall survival rates after surgery, according to the SMI classification. The SMI group with lower values (SMI values < 6.25 kg/m2 and < 5.17 kg/m2 in male and female patients, respectively) had significantly shorter survival rates than the SMI group with higher values (P = 0.019). SMI: smooth muscle index.
Figure 3
Figure 3
The differences in cumulative survival rates after surgery from cancer-related deaths, according to the SMI classification. Patients with lower values of SMI had significantly shorter survivals than those with higher values of SMI (P = 0.013). SMI: smooth muscle index.

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