Preoperative Cachexia Predicts Poor Outcomes in Young Rather Than Elderly Gastric Cancer Patients: A Prospective Study

CONCLUSION

In our prospective study, we found that cachexia was an independent risk factor for OS in GC patients. Additionally, cachexia could predict poor outcome in younger GC patients; therefore, greater attention should be paid to cachexia in younger patients.

Ethics approval and consent to participate

All participants provided their written informed consent, and the protocol for this study was approved by the ethics committee of The First Affiliated Hospital of Wenzhou Medical University and The Second Affiliated Hospital of Wenzhou Medical University.

Availability of data and materials

The datasets used during the current study are available from the corresponding author on reasonable request.

Abbreviations

GC, gastric cancer; ASA, American Society of Anesthesiologists; BMI, body mass index; CI, confidence interval; NLR, neutrophil/lymphocyte ratio; PLR, platelet/lymphocyte ratio; NRS, nutritional risk screening; TNM, tumor, lymph node, metastasis.

Acknowledgments

The authors thank all the participants in this study and the members of our research team. This study was funded by the Department of Health of Zhejiang Province, China (grant no. 2016DTA006), and the Wenzhou Municipal Science and Technology Bureau (grant no. Y20150057).

Disclosure

The authors declare that they have no competing interests in this work.

Xiaodong Chen,1,* Yunpeng Zeng,1,* Yunshi Huang,2 Jingxuan Xu,1 Weiyang Meng,3 Xiang Wang,1 Ce Zhu,2 Guanbao Zhu,2 Chenchen Mao,1 Xian Shen1,2
1Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Emergency Medical, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
Correspondence: Chenchen Mao; Xian Shen
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 West College Road, Wenzhou, Zhejiang Province, People’s Republic of China
Tel +86 05 778 800 2709
Email [email protected]; [email protected]
*These authors contributed equally to this work

References

1. Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12:489–495. doi:10.1016/S1470-2045(10)70218-7

2. Porporato PE. Understanding cachexia as a cancer metabolism syndrome. Oncogenesis. 2016;5:e200. doi:10.1038/oncsis.2016.3

3. Argiles JM, Busquets S, Stemmler B, Lopez-Soriano FJ. Cancer cachexia: understanding the molecular basis. Nat Rev Cancer. 2014;14:754–762. doi:10.1038/nrc3829

4. Mondello P, Lacquaniti A, Mondello S, et al. Emerging markers of cachexia predict survival in cancer patients. BMC Cancer. 2014;14:828. doi:10.1186/1471-2407-14-828

5. Bachmann J, Buchler MW, Friess H, Martignoni ME. Cachexia in patients with chronic pancreatitis and pancreatic cancer: impact on survival and outcome. Nutr Cancer. 2013;65:827–833. doi:10.1080/01635581.2013.804580

6. Fukuta A, Saito T, Murata S, et al. Impact of preoperative cachexia on postoperative length of stay in elderly patients with gastrointestinal cancer. Nutrition. 2018;58:65–68. doi:10.1016/j.nut.2018.06.022

7. Arthur ST, Van Doren BA, Roy D, et al. Cachexia among US cancer patients. J Med Econ. 2016;19:874–880. doi:10.1080/13696998.2016.1181640

8. Evans WJ, Morley JE, Argiles J, et al. Cachexia: a new definition. Clin Nutr. 2008;27:793–799. doi:10.1016/j.clnu.2008.06.013

9. Prado CM, Sawyer MB, Ghosh S, et al. Central tenet of cancer cachexia therapy: do patients with advanced cancer have exploitable anabolic potential? Am J Clin Nutr. 2013;98:1012–1019. doi:10.3945/ajcn.113.060228

10. MF N. Cachexia – an intrinsic factor in wound healing. Int Wound J. 2010;7:107–113. doi:10.1111/j.1742-481X.2010.00663.x

11. Sun X, Liu X, Liu J, et al. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I-II gastric cancer. Chin J Cancer. 2016;35:57. doi:10.1186/s40880-016-0122-2

12. Fearon K, Arends J, Baracos V. Understanding the mechanisms and treatment options in cancer cachexia. Nat Rev Clin Oncol. 2013;10:90–99. doi:10.1038/nrclinonc.2012.209

13. Zheng HL, Lu J, Li P, et al. Effects of preoperative malnutrition on short- and long-term outcomes of patients with gastric cancer: can we do better? Ann Surg Oncol. 2017;24:3376–3385. doi:10.1245/s10434-017-5998-9

14. Zhang Y, Wang JP, Wang XL, et al. Computed tomography-quantified body composition predicts short-term outcomes after gastrectomy in gastric cancer. Curr Oncol. 2018;25:e411–e422. doi:10.3747/co.25.4014

15. Cunningham-Rundles S, McNeeley DF, Moon A Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol. 2005;115:1119–1128; quiz 1129. doi:10.1016/j.jaci.2005.04.036

16. Kizer NT, Thaker PH, Gao F, et al. The effects of body mass index on complications and survival outcomes in patients with cervical carcinoma undergoing curative chemoradiation therapy. Cancer. 2011;117:948–956. doi:10.1002/cncr.25544

17. Moon HG, Han W, Noh DY. Underweight and breast cancer recurrence and death: a report from the Korean Breast Cancer Society. J Clin Oncol. 2009;27:5899–5905. doi:10.1200/JCO.2009.22.4436

18. Karmali R, Alrifai T, Fughhi IAM, et al. Impact of cachexia on outcomes in aggressive lymphomas. Ann Hematol. 2017;96:951–956. doi:10.1007/s00277-017-2958-1

19. Naito T, Okayama T, Aoyama T, et al. Unfavorable impact of cancer cachexia on activity of daily living and need for inpatient care in elderly patients with advanced non-small-cell lung cancer in Japan: a prospective longitudinal observational study. BMC Cancer. 2017;17:800. doi:10.1186/s12885-017-3795-2

20. Ali S, Garcia JM. Sarcopenia, cachexia and aging: diagnosis, mechanisms and therapeutic options – a mini-review. Gerontology. 2014;60:294–305. doi:10.1159/000356760

21. Wen HS, Li X, Cao YZ, et al. Clinical studies on the treatment of cancer cachexia with megestrol acetate plus thalidomide. Chemotherapy. 2012;58:461–467. doi:10.1159/000346446

22. Stewart Coats AJ, Ho GF, Prabhash K, et al. Espindolol for the treatment and prevention of cachexia in patients with stage III/IV non-small cell lung cancer or colorectal cancer: a randomized, double-blind, placebo-controlled, international multicentre phase II study (the ACT-ONE trial). J Cachexia Sarcopenia Muscle. 2016;7:355–365. doi:10.1002/jcsm.12126

Source: Cancer Management and Research.
Originally published September 2, 2019.

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