|Table of Contents|

Predictive value of skeletal muscle mass index of the third lumbar spine and controlling nutritional status score for prognosis in patients with gastric cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 21
Page:
3985-3991
Research Field:
Publishing date:

Info

Title:
Predictive value of skeletal muscle mass index of the third lumbar spine and controlling nutritional status score for prognosis in patients with gastric cancer
Author(s):
QIAN Xuewei; ZHU Qinqin; JIANG Xiaohui
Department of Gastrointestinal Surgery，Affiliated Tumor Hospital，Nantong University，Jiangsu Nantong 226000，China.
Keywords:
skeletal muscle mass index; controlling nutritional status score; gastric cancer; prognosis
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2023.21.015
Abstract:
Objective:To investigate the prognostic value of skeletal muscle mass index of the third lumbar spine（L3-SMI) and controlling nutritional status（CONUT) scores in patients with gastric cancer after surgery.Methods:The clinical and survival data of 528 patients who underwent gastric cancer surgery in our hospital from January 2017 to December 2020 were retrospectively analyzed.The optimal cut-off values of L3-SMI for patients of different genders were determined by the receiver operating characteristic(ROC) curve.The clinical pathological characteristics of patients with different L3-SMI and CONUT scores were compared.The Kaplan-Meier method was used to analyze survival.Cox proportional hazards regression model was used to analyze the influencing factors for prognosis of patients with gastric cancer by univariate and multivariated regression.Nomogram prediction models of overall survival(OS) of patients with gastric cancer were established by the R language software.The internal validation and accuracy of the nomograms were determined by the calculation of concordance index(C-index).Calibration curve was used to evaluate nomograms efficiency.Results:The best cut-off value of preoperative L3-SMI for predicting the prognosis of gastric cancer patients was 43.95 cm2/m2 for male and 37.6 cm2/m2 for female，and the area under the curve（AUC) values were 0.729（95%CI 0.672~0.785) and 0.680（95%CI 0.607~0.753).The 1-，3-and 5-year cumulative overall survival rates were 97.1%，69.4% and 33.6% of patients with low L3-SMI level，and 98.4%，78.4% and 52.3% of patients with high L3-SMI level（χ2=31.718，P<0.001).The 1-，3-and 5-year cumulative overall survival rates were 98.8%，80.2% and 56.4% of patients with low CONUT score，and 96.7%，67.6% and 29.0% with high CONUT score（χ2=48.240，P<0.001).The univariate and multivariate Cox regression analysis showed that L3-SMI level（high:HR=0.581，95%CI:0.459~0.735) and CONUT level（high:HR=1.999，95%CI:1.574~2.539) were independent factors influencing the OS of patients with gastric cancer after surgery（P<0.001).According to the OS nomograms predict models of gastric cancer patients established by multivariate Cox regression analysis，the C-index was 0.671(95%CI:0.639~0.703).The calibration curve of the nomograms showed high consistence of predict and actual curves.Conclusion:The preoperative L3-SMI and CONUT scores are independent influencing factors for prognosis of patients with gastric cancer after surgery.Early detection of L3-SMI and CONUT scores can help predict the prognosis of patients with gastric cancer，which can provide reference and help for clinical decision.

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Memo

Memo:
江苏省南通市科技计划指导性项目（编号：JCZ20133）
Last Update: 2023-09-28