Abstract 455P
Background
Sarcopenia or skeletal muscle depletion is a poor prognostic factor for gastric cancer (GC). However, existing cut-off values of skeletal muscle index (SMI) for defining sarcopenia have been found to have limitations when clinically applied. This study aimed to determine the optimal cut-off for SMI to predict severe toxicities of chemotherapy and overall survival (OS) in patients with advanced GC.
Methods
Patients with metastatic gastric adenocarcinoma who received first-line palliative chemotherapy between January 2014 and December 2021 at Queen Mary Hospital, Hong Kong, were included in this study. The SMI was determined via a pre-chemotherapy computed tomography scan. Optimal cut-off points of SMI were identified by recursive partitioning analysis. Univariate and multivariate analyses evaluating risk factors of severe chemotherapy toxicities and OS were also performed.
Results
A total of 158 patients (male: 108 (68.4%), median age: 65.3) were included. The SMI cut-off to define low SMI was ≤33 cm2/m2 for males and ≤28 cm2/m2 for females; 30 patients (19.0%) had low SMI. Patients with low SMI had a higher incidence of haematological toxicities (63.3% vs. 32.0%, p = 0.001) and non-haematological toxicities (66.7% vs. 36.7%, p = 0.003). Multivariable analysis indicated that low SMI and low serum albumin (≤28 g/L) were independent predictive factors of haematological toxicity, while low SMI and neutrophil-lymphocyte ratio ≥5 were predictive factors of non-haematological toxicity. Moreover, patients with low SMI had a significantly shorter OS (p = 0.011), lower response rate to chemotherapy (p = 0.045), and lower utilisation of subsequent lines of treatment (p < 0.001).
Conclusions
Using prechemotherapy SMI cut-off can identify individuals with higher risk of severe chemotherapy toxicities and worse prognosis.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.