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.
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.