Changes In Body Composition Before And After Neoadjuvant Chemotherapy In Locally Advanced Gastric Cancer Are Used To Predict The Efficacy Of Chemotherapy

Objective: To explore the changes of body composition in patients with locally advanced gastric cancer before and after neoadjuvant chemotherapy,predict the efficacy of neoadjuvant chemotherapy,and evaluate the value of short-term complications and long-term prognosis.Methods: Through the method of retrospective analysis,the general data,clinicopathological data and imaging data of patients with locally advanced gastric cancer who underwent neoadjuvant chemotherapy and surgery in Qing Hai University Affiliated Hospital(QUAH)from January 2012 to December 2018 were collected.Through the CT scan and skeletal muscle radiation density obtained by clinicians before operation and neoadjuvant chemotherapy,the skeletal muscle index,subcutaneous fat index and visceral fat index were evaluated,and the data were analyzed by SPSS 26.0.Results:1.There were significant differences in body components and muscle index before and after neoadjuvant chemotherapy,P=0.023(P<0.05).2.The body component pattern was analyzed according to the degree of pathological remission(≥50%vs<50%).The results showed that there were differences in muscle density before neoadjuvant chemotherapy,indicating that the muscle density of patients with pathological remission≥50% was significantly higher than that of patients with pathological remission <50%(P=0.048,P<0.05).The changes of muscle index and muscle density before and after neoadjuvant chemotherapy in patients with pathological remission≥50% were significantly higher than those with pathological remission<50%(P<0.05).The change of muscle index before and after neoadjuvant chemotherapy can independently predict pathological remission(OR=1.308,P<0.001).3.In the survival analysis,the long-term survival of patients with different△SMI was different.The OS of patients with △SMI≥1.2 was significantly better than that of patients with △SMI<1.2(P<0.05).In univariate analysis,gender,Lauren’s classification,yp TNM stage,postoperative chemotherapy and △SMI were the predictors of OS(OR>1);In the multivariate analysis of OS,only △SMI(OR:1.744,95%CI:0.950-3.313,P=0.072)and yp TNM stage were independent prognostic factors,indicating that △SMI≥1.2 can independently predict better overall survival.Conclusion: There is a close and complex correlation between body composition,tumor response and prognosis of patients with locally advanced gastric cancer receiving neoadjuvant chemotherapy.The index of △SMI is expected to become a simple,objective,effective and noninvasive index for evaluating the efficacy of chemotherapy,evaluating the timing of surgery and predicting the overall survival of patients.