Retrospective Analysis: Quantitative Measurement Of Adipose Tissue Using CT Images And Its Impact On Overall Survival In Gastric Cancer Patients After Gastrectomy

Objective: The aim of this retrospective study was to evaluate the association of CT(Computed Tomography)-measured abdominal adipose including BMI(Body Mass Index),age,gender,tumor size,stages,grades and the effect of surgery on overall survival after Gastrectomy for gastric adenocarcinoma.Materials and Method : This retrospective study included 62 consecutive patients with histo-pathologically proved as gastric adenocarcinoma undergone gastrectomy at First Affiliated Hospital of Guangxi Medical University,identified between September 2011-December 2015.BMI was calculated before the operation and Body fat parameters [TAT(total abdominal fat),VAT(visceral abdominal fat),SAT(subcutaneous abdominal fat)] were measured retrospectively at umbilicus level from one cross sectional CT images prior to the surgery and also on the CT images performed during the follow up at the interval of around 6months.Association between the body adipose tissue,BMI and other factors on surgical outcome and overall survival was evaluated with survival analysis.Results : In follow up of about 6 months after the surgery,there was a significant decreases in TAT,VAT and SAT values(p<0.001).According to preoperative Fat survival analysis the median overall survival of all the included patients was 337 days(95% CI: 249-425 days).In univariate survival analysis there was a significant positive correlation between tumor stage,preoperative TAT and preoperative SAT(i.e.lower tumor stage,significant amount of preoperative TAT and preoperative SAT had higher survival rate)were associated with longer OS(P< 0.05)but showed no positive significant differences with patient's other characteristics like age,sex,tumor size,tumor grade BMI and VAT.By the multivariate analysis high preoperative SAT were independently significant(P=0.004;<0.05)with the overall survival(OS)(OR0.992,95%CI 0.992-0.997).Conclusion:This study provided the evidence that high subcutaneous Adipose tissue(SAT)measured prior to the surgery was liable to be useful predictive bio-markers for the survival in advanced gastric cancer patients after the gastrectomy.Abdominal fat distribution may influence the biological features and is likely to be useful predictive bio-markers for the survival of patients with advanced gastric adenocarcinoma.