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De Ruvo N, Fenocchi S, Veronesi L, Missori G, Ricciardolo AA, Rossi EG, Sorrentino L, Cautero N, Serra F, Gelmini R. Prognostic factors in gastric cancer patients: a 10-year mono-institutional experience. Front Surg 2024; 11:1321981. [PMID: 38362460 PMCID: PMC10867173 DOI: 10.3389/fsurg.2024.1321981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/11/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Gastric cancer (GC) is one of the main causes of death from cancer globally. Long-term survival, especially in Western countries, remains dismal, with no significant improvements in recent years. Therefore, precise identification of clinical and pathological risk factors is crucial for prognosis, as it allows a better selection of patients suitable for oncologically radical treatments and contributes to longer survivals. Methods We devised a retrospective observational longitudinal study over 10 years of experience with GC patients operated with curative intent. Results Several factors were thoroughly investigated in a multivariate analysis to look for significance as independent risk factors for disease-free survival. Our results showed that only BMI, pTNM, and lymph node ratio expressed hazard ratios with implications for survival in our series of patients. Discussion Although limited by the retrospective nature of the study, this is one of the few cancer reports from Northern Italy showing results over 10 years, which may in our view, have an impact on decision-making processes for multidisciplinary teams dedicated to the care of gastric cancer patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - F. Serra
- General, Oncological and Emergency Surgery Unit, Department of Surgery, AOU Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy
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Ricciardolo AA, De Ruvo N, Serra F, Prampolini F, Solaini L, Battisti S, Missori G, Fenocchi S, Rossi EG, Sorrentino L, Salati M, Spallanzani A, Cautero N, Pecchi A, Ercolani G, Gelmini R. Strong impact of sarcopenia as a risk factor of survival in resected gastric cancer patients: first Italian report of a Bicentric study. Updates Surg 2021; 74:283-293. [PMID: 34699033 DOI: 10.1007/s13304-021-01175-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
Gastric cancer (GC) accounts for 4% of all cancers in Europe. Sarcopenia is a complex syndrome characterized by a loss of muscle mass and function associated with age, often present in neoplastic patients. Recently, several studies have shown a significant association between sarcopenia and poor prognosis in various pathological conditions. The current observational retrospective study investigates the association between sarcopenia and overall survival (OS) and recurrence-free survival (RFS) in patients with GC undergoing up-front surgery with curative intent. Resected GC patients' clinical records and CT images were retrospectively assessed. The preoperative CT calculation of the skeletal muscle index (SMI) at L3 level allowed us to categorize patients as sarcopenic or not. Kaplan-Meyer and univariate and multivariate Cox regression analyses were performed to determine the difference in survival and presence of independent prognostic factors. Fifty-five patients, 28 male and 27 female, out of 298 studied for gastric cancer were enrolled in the current study from two cancer referral centers in Italy. The preoperative CT calculation of the SMI at L3 level allowed us to identify 39 patients with and 16 without sarcopenia. A statistically significant difference between the sarcopenic and non-sarcopenic groups was observed in both OS and RFS (p < 0.023; p < 0.006). Moreover, sarcopenia was strongly correlated to a higher risk of recurrence in univariate and multivariate analysis (p < 0.02). Sarcopenia can be considered a critical risk factor for survival in patients with resectable GC treated with up-front surgery. Identifying sarcopenic patients at the time of diagnosis would direct selection of patients who could benefit from early nutritional and/or physical treatments able to increase their muscle mass and possibly improve the prognosis. More extensive multicenter studies are needed to address this issue.
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Affiliation(s)
- A A Ricciardolo
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - N De Ruvo
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy.
| | - F Serra
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - F Prampolini
- Department of Radiology, AOU of Modena, University of Modena and Reggio Emilia, via del Pozzo 71, 41125 Modena Italy, Modena, Italy
| | - L Solaini
- Department Of Medical and Surgical Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forli, Italy
| | - S Battisti
- Istituto Scientifico Romagnolo Per Lo Studio E La Cura Dei Tumori (IRST) IRCCS, Meldola, Italy
| | - G Missori
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - S Fenocchi
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - E G Rossi
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - L Sorrentino
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - M Salati
- Department of Oncology, AOU of Modena, University of Modena and Reggio Emilia, via del Pozzo 71, 41125 Modena Italy, Modena, Italy
| | - A Spallanzani
- Department of Oncology, AOU of Modena, University of Modena and Reggio Emilia, via del Pozzo 71, 41125 Modena Italy, Modena, Italy
| | - N Cautero
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
| | - A Pecchi
- Department of Radiology, AOU of Modena, University of Modena and Reggio Emilia, via del Pozzo 71, 41125 Modena Italy, Modena, Italy
| | - G Ercolani
- Department Of Medical and Surgical Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forli, Italy
| | - R Gelmini
- Department of General and Specialistic Surgery, Unit of General, Emergency and Oncological Surgery, Policlinico, AOU of Modena University of Modena and Reggio Emilia, Via del Pozzo 71, 41125, Modena, Italy
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Salati M, Marcheselli L, Ruvo ND, Esposito G, Fenocchi S, Cucciarrè G, Serra F, Cautero N, Cabry F, Gelmini R, Vittimberga G, Radi G, Solaini L, Morgagni P, Ercolani G, Ghidini M, Grizzi G, Ratti M, Gelsomino F, Luppi G, Dominici M, Spallanzani A. SO-12 Multicentre validation of an immune-inflammation-based nomogram to predict survival in western resectable gastroesophageal adenocarcinoma: The NOMOGAST. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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