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Abstract：
Neoadjuvant chemotherapy (NT) followed by radical surgery is the standard treatment for locally advanced gastric cancer (GC). The incidence of sarcopenia in upper gastrointestinal tract malignancies is very high, and it may be increased after NT. This study aimed to evaluate the impact of NT on body composition. A retrospective study of patients with locally advanced GC undergoing gastrectomy who had received NT in a tertiary hospital between 2012 and 2019 was conducted. CT measured the skeletal muscle index, total psoas area, and visceral and subcutaneous adipose tissue before and after NT. Of the 180 gastrectomies for GC, 61 patients received NT. During NT, changes in body composition were observed with a decrease in the skeletal muscle mass index (SMMI -2.5%; p < 0.001), and these changes were significantly greater in men (SMMI -10.55%). Before surgery, patients who received NT presented 15% more sarcopenia than those without NT (p = 0.048). In conclusion, patients with locally advanced gastric cancer who receive NT have significant changes in body composition during chemotherapy. These changes, which are at the expense of a loss of muscle mass, lead to an increased incidence of pre-surgical sarcopenia.
摘要：
新辅助化疗（NT）和根治性手术是局部晚期胃癌（GC）的标准治疗方法。上消化道恶性肿瘤中肌肉减少症的发病率很高，NT后可能会增加。本研究旨在评估NT对身体成分的影响。对2012年至2019年在三级医院接受NT的局部晚期GC行胃切除术的患者进行了回顾性研究。CT测量骨骼肌指数,总腰肌面积,以及NT前后的内脏和皮下脂肪组织。在GC的180个胃切除术中，61例患者接收NT。在NT期间,观察到身体成分的变化，骨骼肌质量指数降低（SMMI-2.5％；p<0.001），这些变化在男性中明显更大（SMMI-10.55％）。手术前,接受NT的患者的肌肉减少症发生率比没有NT的患者高15%(p=0.048).总之,接受NT治疗的局部晚期胃癌患者在化疗期间身体成分发生显著变化.这些变化,以肌肉质量损失为代价，导致术前肌肉减少症的发生率增加。
