We sought to elucidate factors contributing to the grip strength (GS) decline in patients with gastrointestinal diseases (Ga-Ds, n = 602, 379 males, median age = 72 years). The GS decline in males and females was defined as <28 kg and <18 kg, respectively, following the current Asian guidelines. The median GS (male) was 28.8 kg, and GS decline (male) was found in 169 patients (44.6%). The median GS (female) was 17.5 kg, and GS decline (female) was found in 122 patients (54.7%). Advanced cancer was identified in 145 patients (24.1%). In terms of the univariate analysis of parameters of the GS decline, age (p < 0.0001), gender (p = 0.0181), body mass index (BMI, p = 0.0002), ECOG-PS (p < 0.0001), SARC-F score (p < 0.0001), hemoglobin value (p < 0.0001), total lymphocyte count (p < 0.0001), serum albumin value (p < 0.0001), C reactive protein (CRP) value (p < 0.0001), and estimated glomerular filtration rate were statistically significant. In terms of the multivariate analysis, age (p < 0.0001), BMI (p = 0.0223), hemoglobin value (p = 0.0186), serum albumin value (p = 0.0284), the SARC-F score (p = 0.0003), and CRP value (p < 0.0001) were independent parameters. In conclusion, the GS decline in patients with Ga-Ds is closely associated with not only the primary factor (i.e., aging) but also secondary factors such as inflammatory factors and nutritional factors.
Background/Aim: To prospectively evaluate the efficacy and safety of the BNT162b2 vaccine in solid cancer patients undergoing systemic chemotherapy (n=63). Patients and Methods: COVID-19 anti-spike protein antibody levels were measured before the first BNT162b2 vaccination, just before the second BNT162b2 vaccination, one month after the second BNT162b2 vaccination, and 3 months after the second BNT162b2 vaccination. Anti-spike protein antibody seropositivity was set at ≥0.8 U/ml. Results: Colorectal cancer was the most commonly observed primary disease (36.5%). ECOG-PS 0 was observed in the majority (52.4%) of patients. The overall response rate and the median (range) anti-spike protein antibody levels in the whole cohort at 3 months after the second BNT162b2 vaccination were 98.4% (62/63) and 206 (0.4-3,813) U/ml. None of the patients required postponement or discontinuation of systemic chemotherapy because of an adverse reaction. Conclusion: The BNT162b vaccine in solid cancer patients undergoing systemic chemotherapy is effective and safe.The COVID-19 pandemic is still ongoing, and antibody acquisition against COVD-19 through vaccination is necessary for infection control (1, 2). Currently, several COVID-19 vaccines are under development worldwide (3,4). Three types of COVID-19 vaccines [Pfizer (BNT162b2), Moderna (mRNA-1273), and AstraZeneca (ChAdOx1 nCov19)] are currently approved in Japan, all of which have shown high efficacy (94-95%) in preventing the onset of symptomatic .The Pfizer BNT162b2 vaccine is a lipid nanoparticleformulated, nucleoside-modified RNA (mRNA) vaccine encoding a prefusion-stabilized, membrane-anchored severe acute respiratory syndrome coronavirus 2 full-length spike protein (8). In Japan, the BNT162b2 mRNA vaccine was approved by the regulatory authorities in February 2021, with priority vaccination for healthcare workers. Priority vaccination for the elderly and patients with underlying diseases had also been initiated in April 2021. Reports have begun to emerge from both Japan and overseas on the rate of antibody acquisition and reduction of COVID-19 infection rates through vaccination for COVID-19 in healthy subjects (8-11). On the other hand, cancer patients have a significantly higher incidence, severity, and mortality rate of COVID-19 infection, and patients with solid tumors are also priority 2780
Aims: In this study, we focused on the fat ratio within psoas muscle (FRPM) and sought to clarify the impact of FRPM on overall survival (OS) in stage IV gastric cancer (GC) patients undergoing systemic chemotherapy ( n = 79, median age = 69 years, 59 males). Methods: The median FRPM was 1.67 %. Forty patients with FRPM ≥1.67 % were defined as the FRPM-high group, and the remaining 39 patients was defined as the FRPM-low group. The median PMI in male and female patients was 4.35 cm 2 /m 2 and 2.88 cm 2 /m 2 . Thirty male patients with PMI ≥4.35 cm 2 /m 2 and 10 female patients with PMI ≥2.88 cm 2 /m 2 was defined as the PMI-high group, and the remaining 39 patients was defined as the PMI-low group. Results: The 1-, 2- and 3- year cumulative OS rate for all cases was 70.8%, 24.3% and 14.6%. The proportion of ECOG-PS 2 or 3 in patients with FRPM-high and FRPM-low was 17.5% (7/40) and 2.6% (1/39). The 1-, 2- and 3- year cumulative OS rate in patients with FRPM-high and FRPM-low was 67.3%, 14.3% and 7.6% in the FRPM-high group and 74.8%, 40.5% and 32.4% in the FRPM-low group ( P = 0.0341). The 1-, 2- and 3- year cumulative OS rate in patients with PMI-high and PMI-low was 86.7%, 40.4% and 30.0% in the PMI-high group and 55.8%, 12.8% and 6.4% in the PMI-low group ( P < 0.0001). In the multivariate analysis of factors associated with OS, PMI ( P = 0.0047) and FRPM ( P = 0.0019) were independent predictors for the OS. Conclusion: Higher FRPM can be associated with decreased physical activity, and not only skeletal muscle mass but also skeletal muscle function can be an essential prognostic factor in stage IV GC patients undergoing systemic chemotherapy.
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