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SHR Neuro Cancer Cardio Lipid Metab Microb

Huemer, F; Hecht, S; Scharinger, B; Schlintl, V; Rinnerthaler, G; Schlick, K; Heregger, R; Melchardt, T; Wimmer, A; Mühlbacher, I; Koch, OO; Neureiter, D; Klieser, E; Seyedinia, S; Beheshti, M; Greil, R; Weiss, L.
Body composition dynamics and impact on clinical outcome in gastric and gastro-esophageal junction cancer patients undergoing perioperative chemotherapy with the FLOT protocol.
J Cancer Res Clin Oncol. 2023; 149(7):3051-3064 Doi: 10.1007/s00432-022-04096-w [OPEN ACCESS]
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Co-authors Med Uni Graz: Rinnerthaler Gabriel; Schlintl Verena
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Abstract:: PURPOSE: Perioperative chemotherapy with FLOT constitutes a standard of care approach for locally advanced, resectable gastric or gastro-esophageal junction (GEJ) cancer. We aimed at investigating anthropometric, CT-based and FDG-PET-based body composition parameters and dynamics during this multidisciplinary approach and the impact on clinical outcomes. METHODS: This retrospective, single-center study was based on medical records and (FDG-PET)-CT images among gastric/GEJ cancer patients undergoing perioperative FLOT chemotherapy. RESULTS: Between 2016 and 2021, 46 gastric/GEJ cancer patients started perioperative FLOT at our tertiary cancer center (Salzburg, Austria). At a median follow-up of 32 months median PFS was 47.4 months and median OS was not reached. The skeletal muscle index (SMI, cm²/m²) turned out to be the only body composition parameter with a statistically significant decrease during pre-operative FLOT (51.3 versus 48.8 cm²/m², p = 0.02). Neither pre-FLOT body mass index (BMI), nor SMI had an impact on the duration of pre-operative FLOT, the time interval from pre-operative FLOT initiation to surgery, the necessity of pre-operative or post-operative FLOT de-escalation or the likelihood of the start of postoperative chemotherapy. Pre-FLOT BMI (overweight versus normal, HR: 0.11, 95% CI: 0.02-0.65, p = 0.02) and pre-FLOT SMI (sarcopenia versus no sarcopenia, HR: 5.08, 95% CI: 1.27-20.31, p = 0.02) were statistically significantly associated with PFS in the multivariable analysis. CONCLUSION: The statistically significant SMI loss during pre-operative FLOT and the meaningful impact of baseline SMI and BMI on PFS argue for the implementation of a nutritional screening and support program prior to the initiation of pre-operative FLOT in clinical routine.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Retrospective Studies - administration & dosage; Fluorodeoxyglucose F18 - administration & dosage; Nutrition Assessment - administration & dosage; Adenocarcinoma - drug therapy; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Nutritional Status - administration & dosage; Stomach Neoplasms - drug therapy, surgery; Esophagogastric Junction - surgery; Body Composition - administration & dosage
Find related publications in this database (Keywords): Gastric cancer; Perioperative chemotherapy; Sarcopenia; Skeletal muscle index; Body mass index