Abstract：
OBJECTIVE: The sex-specific effect of the visceral-to-subcutaneous fat ratio (VSR) before gastrectomy on postoperative survival in patients with gastric cancer (GC) remains unclear. This study measured the preoperative VSR in patients with GC and analyzed its relationship with 5-year overall survival (OS) and relapse-free survival (RFS) by sex.
METHODS: This prospective study included 540 patients with GC undergoing gastrectomy. Preoperative visceral and subcutaneous fat volumes were measured using computed tomography, and the VSR was calculated. A cutoff value for the VSR was established using 5-year survival data, and its association with survival was analyzed using the Kaplan-Meier method, log-rank tests, and multivariate regression analysis.
RESULTS: Among the 459 patients analyzed (300 males and 159 females), OS and RFS were significantly lower in the low-VSR group than in the high-VSR group in males (OS: 76.2% vs. 88.1%, p=0.01; RFS: 74.6% vs. 86.0%, p=0.02). In females, no difference in OS was observed between the groups, whereas the high-VSR group had significantly lower RFS than that of the low-VSR group (RFS: 74.7% vs. 88.9%, p=0.01). Multivariate analysis showed that a low VSR was an independent poor predictor of OS in males and a high VSR was an independent poor predictor of RFS in females.
CONCLUSIONS: In patients with GC, the sex-dependent preoperative VSR was a potentially useful predictor of postoperative survival.
METHODS: This prospective study included 540 patients with GC undergoing gastrectomy. Preoperative visceral and subcutaneous fat volumes were measured using computed tomography, and the VSR was calculated. A cutoff value for the VSR was established using 5-year survival data, and its association with survival was analyzed using the Kaplan-Meier method, log-rank tests, and multivariate regression analysis.
RESULTS: Among the 459 patients analyzed (300 males and 159 females), OS and RFS were significantly lower in the low-VSR group than in the high-VSR group in males (OS: 76.2% vs. 88.1%, p=0.01; RFS: 74.6% vs. 86.0%, p=0.02). In females, no difference in OS was observed between the groups, whereas the high-VSR group had significantly lower RFS than that of the low-VSR group (RFS: 74.7% vs. 88.9%, p=0.01). Multivariate analysis showed that a low VSR was an independent poor predictor of OS in males and a high VSR was an independent poor predictor of RFS in females.
CONCLUSIONS: In patients with GC, the sex-dependent preoperative VSR was a potentially useful predictor of postoperative survival.
摘要：
目的：胃切除术前内脏-皮下脂肪比(VSR)对胃癌(GC)患者术后生存的性别特异性影响尚不清楚。这项研究测量了GC患者的术前VSR，并按性别分析了其与5年总生存率（OS）和无复发生存率（RFS）的关系。
方法：这项前瞻性研究包括540例接受胃切除术的GC患者。术前内脏和皮下脂肪体积测量使用计算机断层扫描，并计算了VSR。使用5年生存数据确定VSR的截止值，并使用Kaplan-Meier方法分析其与生存率的关系，对数秩测试，和多元回归分析。
结果：在分析的459例患者中（男性300例，女性159例），男性低VSR组的OS和RFS明显低于高VSR组（OS：76.2％vs.88.1%,p=0.01；RFS：74.6%vs.86.0%,p=0.02)。在女性中，两组间OS无差异,而高VSR组的RFS明显低于低VSR组(RFS：74.7%vs.88.9%,p=0.01)。多变量分析表明，低VSR是男性OS的独立不良预测因子，高VSR是女性RFS的独立不良预测因子。
结论：在GC患者中，性别依赖性术前VSR是术后生存的潜在有用预测因子.
方法：这项前瞻性研究包括540例接受胃切除术的GC患者。术前内脏和皮下脂肪体积测量使用计算机断层扫描，并计算了VSR。使用5年生存数据确定VSR的截止值，并使用Kaplan-Meier方法分析其与生存率的关系，对数秩测试，和多元回归分析。
结果：在分析的459例患者中（男性300例，女性159例），男性低VSR组的OS和RFS明显低于高VSR组（OS：76.2％vs.88.1%,p=0.01；RFS：74.6%vs.86.0%,p=0.02)。在女性中，两组间OS无差异,而高VSR组的RFS明显低于低VSR组(RFS：74.7%vs.88.9%,p=0.01)。多变量分析表明，低VSR是男性OS的独立不良预测因子，高VSR是女性RFS的独立不良预测因子。
结论：在GC患者中，性别依赖性术前VSR是术后生存的潜在有用预测因子.
