Impact of nutritional deficiency and sarcopenia on the efficacy of neoadjuvant chemotherapy in patients with locally advanced gastric cancer: a retrospective study


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Abstract

Background. The incidence of nutritional deficiency (ND) among patients with locally advanced gastric cancer (LAGC) ranges from 40 to 60%, sarcopenia - 30%. The evaluation of the effect of ND and sarcopenia on the efficacy of neoadjuvant chemotherapy (NACT) in patients with LAGC is extremely important. Objective. Assessment of the prognostic role of ND and sarcopenia in patients with LAGC treated with NACT. Methods. Retrospective analysis of data on 100 patients with LAGC, mean age 56.9 (45.9-67.9) years, who received NACT at the N.N. Petrov National Medical Research Center of Oncology for the period from 2013 to 2018 was performed. ND, sarcopenia, the incidence of complications against the background of NACT, objective response, pathomorphological regression, 5-year event-free and overall survival were assessed. Results. Before the beginning of the NACT, ND was registered in 47% of cases, after the NACT - in 62%; sarcopenia - in 11 and 22%, respectively. Partial regression was observed in 71% of patients without ND versus 41.9% in the group with ND (p=0.001). The pCR rate in patients without ND was 23.7% versus 4.8% in the group with ND (p<0.001). Febrile neutropenia developed 7.8% in the group without ND versus 27.2% in the group with ND (p=0.001). The 5-year event-free survival in patients without ND was 45.1% versus 15.1% in the group with ND (p=0.026); 5-year overall survival - 63.9% versus 24.5%, respectively (p=0.043). The presence of sarcopenia in patients did not affect all of the above parameters. Conclusion. According to the data of a retrospective analysis, ND is an unfavorable prognostic factor for the effectiveness of NACT in patients with LAGC.

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About the authors

N. A Brish

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

T. Yu Semiglazova

N.N. Petrov National Medical Research Centre of Oncology; I.I. Mechnikov North-West State Medical University

Email: tsemiglazova@mail.ru
St. Petersburg, Russia

A. M Karachun

N.N. Petrov National Medical Research Centre of Oncology; I.I. Mechnikov North-West State Medical University

St. Petersburg, Russia

E. V Tkachenko

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

A. S Artemieva

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

L. N Shevkunov

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

Ya. A Ulyanchenko

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

T. S Golovanova

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

Yu. V Alekseeva

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

S. M Sharashenidze

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

L. V Strakh

I.P. Pavlov First Saint-Petersburg State Medical University

St. Petersburg, Russia

L. V Filatova

N.N. Petrov National Medical Research Centre of Oncology; I.I. Mechnikov North-West State Medical University

St. Petersburg, Russia

V. V Semiglazov

N.N. Petrov National Medical Research Centre of Oncology; I.P. Pavlov First Saint-Petersburg State Medical University

St. Petersburg, Russia

B. S Kasparov

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

S. A Protsenko

N.N. Petrov National Medical Research Centre of Oncology

St. Petersburg, Russia

A. M Belyaev

N.N. Petrov National Medical Research Centre of Oncology; I.I. Mechnikov North-West State Medical University

St. Petersburg, Russia

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