Computed tomography-measured body composition: correlation with postoperative morbidity and mortality in patients with gastroesophageal cancer

Abstract

Objective: To determine whether preoperative anthropometric and computed tomography (CT) measurements of body composition can predict postoperative morbidity and mortality in patients with gastric or esophageal cancer. Materials and Methods: This was a retrospective study in which we reviewed the medical records and abdominal CT scans of patients with gastric or esophageal cancer who underwent surgery in 2015 at a cancer center. CT scans performed during routine preoperative evaluation were retrospectively assessed to measure the area of lean body mass at the level of the third lumbar vertebra, as well as the area of visceral and subcutaneous fat. Results: Seventy patients were included in the study. The mean age was 59.9 years (range, 33-82 years), and 47 patients (67.1%) were men. The mean postoperative follow-up period was 14.9 months. Neither postoperative morbidity nor postoperative mortality correlated significantly with gender, age, the type of primary tumor, the presence of comorbidities, smoking status, body mass index, nutritional status, or visceral fat area. The survival rate was higher for patients with normal lean body mass than for those with low lean body mass (hazard ratio = 0.116; 95% confidence interval: 0.015-0.906; p = 0.040). Conclusion: Our data suggest that lean body mass can be a relevant prognostic factor in patients with gastric or esophageal cancer, and that CT measurements should be included in the routine preoperative evaluation, because it may provide information that aids nutritional and clinical care for these patients.

Computed Tomography-Defined Fat Composition as a Prognostic Marker in Gastric Adenocarcinoma: A Systematic Review and Meta-Analysis

“…The paper acquisition is summarized in Figure 1. After a thorough review, 9 studies were suitable for the present analysis [12][13][14][15][16][17][18][19][20]. The following search words were used: "gastric cancer" OR "gastric carcinoma" AND "body composition" OR "visceral fat" OR "visceral fat area.…”

“…Two studies included other cancers in addition to gastric cancer patients. Bitencourt et al [12] also included esophageal-gastric junction cancer, and Carvalho et al…”

“…[13] also included colorectal cancer patients in the analysis [12,13]. All cases were histopathologically defined as adenocarcinomas.…”

“…Out of these, the level of the CT slide was at L3 in five studies [13][14][15][16]19], at L4/5 in one study [12], and at umbilical cord level in another study [18]. In addition, the subcutaneous fat area was assessed, and the SFA was calculated in four studies [12,[14][15][16]. Finally, in two studies, an index approach was performed [17,20].…”

64-Slice Spiral Computerized Tomography under Algebraic Reconstruction Algorithm in the Surgical Treatment of Acquired Immune Deficiency Syndrome Complicated with Gastric Cancer

“…However, as there are a large number of organs in the human body, the density difference among the organs is small, and the contrast is poor, the obtained original CT images often have a lot of noise and artifacts with a poor quality, which affects the judgment of the radiologist. us, the original images need to be enhanced with the help of artificial intelligence algorithms [14][15][16]. e algebraic reconstruction technology (ART) is to reconstruct the image by solving the system of linear equations.…”