2093P - Bioelectrical Impedance phase angle and obesity as a prognostic indicator in metastatic gastric cancer patients receiving second-line chemotherapy

Background

The combination treatment of paclitaxel plus ramucirumab [PACL(W)+RAMU] is a widely accepted option for advanced gastric cancer (AGC) as a second-line chemotherapy to prolong survival. The aim of the study is to identify the validity of bioelectrical impedance analysis (BIA) as a prognosticator in patients receiving PACL(W)+RAMU treatment.

Methods

The study population comprised 189 patients who received PACL(W)+RAMU between Oct. 2019 and Nov. 2022. BIA was conducted at baseline of the PACL(W)+RAMU treatment on all patients and whole body PhA was derived. Continuous variables of other body compartment and blood biochemical values (including complete blood count, serum electrolytes and chemistry) were dichotomized according to the best cut-off values determined by the Contal and O’Quigley methods or the normal values. Kaplan-Meier method and the Cox proportional hazard model were constructed to evaluate the prognostic effect the body component.

Results

Median age of the patients was 59. The cut-off value of PhA was determined as 4.6⁰ at 50 kHz. Median overall survival (OS) of the lower PhA group was 38 weeks (95% CI, 32-45) and 52 weeks (95% CI, 39∼65) for higher PhA group (P=0.021). When combining PhA with obesity degree (current weight/target weight x 100), high phA and low obesity degree (< 116%) demonstrated the favorable OS of 54 weeks (95% CI, 40-68), which contrasts to only 14 weeks (95% CI, 10-18) for low PhA and high obesity degree (≥ 116%) group. In multivariate analysis, the PhA combined with obesity degree is an independent prognosticator for OS (hazard ratio [HR], 6.506 for low PhA and high obesity degree, 95% CI, 3.237-13.076, P<0.001) along with neutrophil-to-lymphocyte ratio and extracellular water.

Conclusions

Bioelectrical impedance component and phase angle could be a useful prognosticator for patients with metastatic gastric cancer. Larger sample size and independent set will be needed to further validate the significance of this study in palliative cancer treatment settings.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.