Skeletal muscle gauge: A superior predictor of neoadjuvant chemoimmunotherapy efficacy in locally advanced gastric cancer.

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-18 DOI:10.1016/j.clnesp.2025.07.028

Zhi-Yong Zhou, Bing Lai, Fa-Yang Lei, Xiang Chen, Jia-Qing Cao, Sheng-Xun Mao, Jiao-Bao Huang

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引用次数: 0

Abstract

Background: Muscle parameters are closely related to the efficacy of neoadjuvant therapy, and this study aims to analyze the predictive value of a novel muscle parameter index (skeletal muscle gauge, SMG) for the efficacy of neoadjuvant chemotherapy and immunotherapy(NCI) in locally advanced gastric cancer(LAGC).

Method: A retrospective analysis was conducted on the clinical pathological data and abdominal CT images of patients with LAGC who received NCI at the Second Affiliated Hospital of Nanchang University from September 2020 to December 2023. The body composition, including skeletal muscle index (SMI), skeletal muscle radiation attenuation (SMRA), and the new skeletal muscle parameter- SMG (obtained by multiplying SMI and SMRA), was calculated using the SliceOmatic software before and after NCI. The relationships between the three skeletal muscle parameters and the NCI efficacy and postoperative complications were analyzed and compared.

Results: A total of 162 patients were included in this study,Before neoadjuvant, the median SMI was 38.1(34.2-44.3)cm/m², SMRA was 44.7(41.1-48.4)HU, and SMG was 1776(1449-1979).Multivariate logistic analysis showed that cN stage (OR: 5.75, 95% CI: 3.21-11.52, p=0.008) and SMG(OR: 0.99, 95% CI: 0.96-0.99, p=0.001) were poor tumor regression (TRG 3 grade). SMI(OR:0.50, 95% CI: 0.29-0.88, p=0.016), SMRA(OR:0.58, 95% CI: 0.36-0.91, p=0.018) and SMG(OR:0.96, 95% CI: 0.96-0.99, p=0.001) are all protective factors for postoperative complications. ROC curve analysis showed that SMG was superior to SMI and SMRA in predicting tumor recession and postoperative complications.

Conclusion: The new skeletal muscle parameters showed better predictive performance in the efficacy of NCI for LAGC and are a promising evaluation indicator, but they still need to be verified by prospective studies with larger samples.

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骨骼肌测量：局部进展期胃癌新辅助化疗免疫治疗效果的优越预测指标。

背景：肌肉参数与新辅助治疗的疗效密切相关，本研究旨在分析一种新型肌肉参数指标（骨骼肌指标，SMG）对局部晚期胃癌（LAGC）新辅助化疗与免疫治疗（NCI）疗效的预测价值。方法：回顾性分析2020年9月至2023年12月在南昌大学第二附属医院接受NCI治疗的LAGC患者的临床病理资料及腹部CT图像。使用SliceOmatic软件计算NCI前后的身体组成，包括骨骼肌指数（SMI）、骨骼肌辐射衰减（SMRA）和新的骨骼肌参数SMG （SMI与SMRA相乘得到）。分析比较三个骨骼肌参数与NCI疗效及术后并发症的关系。结果：本研究共纳入162例患者，新辅助术前中位SMI为38.1(34.2-44.3)cm/m2， SMRA为44.7(41.1-48.4)HU， SMG为1776（1449-1979）。多因素logistic分析显示，cN期（OR: 5.75, 95% CI: 3.21 ~ 11.52, p=0.008）和SMG期（OR: 0.99, 95% CI: 0.96 ~ 0.99, p=0.001）肿瘤回归较差（TRG 3级）。SMI（OR:0.50, 95% CI: 0.29-0.88, p=0.016）、SMRA（OR:0.58, 95% CI: 0.36-0.91, p=0.018）和SMG（OR:0.96, 95% CI: 0.96-0.99, p=0.001）都是术后并发症的保护因素。ROC曲线分析显示SMG在预测肿瘤消退和术后并发症方面优于SMI和SMRA。结论：新的骨骼肌参数对NCI治疗LAGC的疗效有较好的预测效果，是一个有前景的评价指标，但仍需通过更大样本的前瞻性研究进行验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.