Background: The measurement of a single abdominal image on computed tomography (CT) can provide an estimate of the total body skeletal muscle. We evaluate the change of the area of the psoas major muscle (PMMA) in a CT which was performed routinely after gastrectomy in gastric cancer. Methods: A total of 119 gastric cancer patients who underwent gastrectomy were enrolled for the study. A CT image at the top of the iliac crest level was obtained at the following times: 3 postoperative months (POM), 6 POM, 1 postoperative year (POY), 2 POY, 3 POY, and 5 POY. We analyzed the change rate of PMMA after gastrectomy and before or after recurrence. Results: PMMA change after gastrectomy was approximately between -8 and -10% over the 5-year observation period. PMMA in the R2 (macroscopic residual tumor)/recurrence group was lower than that in the no recurrence group, and a significant difference was observed at 2 POY (-21.7 ± 3.6% vs. -7.9 ± 2.3%, p < 0.01). PMMA after freshly diagnosed recurrence had decreased significantly by 14.1 ± 1.8% (p < 0.01). Conclusions: Evaluation of PMMA change by CT after gastrectomy could assist in the diagnosis of the progression of cancer state in gastric cancer patients.

Keywords:
Cancer cachexia, Gastric cancer, Postoperative recurrence , Psoas major muscle, Computed tomography
1.
Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S: Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011;12:489-495.
2.
Rosenberg IH: Summary comments. Am J Clin Nutr 1989;50:1231-1233.
3.
Lieffers JR, Mourtzakis M, Hall KD, McCargar LJ, Prado CM, Baracos VE: A viscerally driven cachexia syndrome in patients with advanced colorectal cancer: contributions of organ and tumor mass to whole-body energy demands. Am J Clin Nutr 2009;89:1173-1179.
4.
Baracos VE, Reiman T, Mourtzakis M, Gioulbasanis I, Antoun S: Body composition in patients with non-small cell lung cancer: a contemporary view of cancer cachexia with the use of computed tomography image analysis. Am J Clin Nutr 2010;91:1133S-1137S.
5.
Martin L, Birdsell L, MacDonald N, Reiman T, Clandinin MT, McCargar LJ, Murphy R, Ghosh S, Sawyer MB, Baracos VE: Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 2013;31:1539-1547.
6.
Japanese Gastric Cancer Association: Japanese Classification of Gastric Carcinoma. The Ed 14. Tokyo, Kanehara Shuppan Co., 2010.
7.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M: Sarcopenia: European consensus on definition and diagnosis. Age Ageing 2010;39:412-423.
8.
Haverkort EB, Reijven PLM, Binnekade JM, de van der Schueren MAE, Earthman CP, Gouma DJ, et al: Bioelectrical impedance analysis to estimate body composition in surgical and oncological patients: a systematic review. Eur J Clin Nutr 2015;69:3-13.
9.
Freedman RJ, Aziz N, Albanes D, Hartman T, Danforth D, Hill S, Sebring N, Reynolds JC, Yanovski JA: Weight and body composition changes during and after adjuvant chemotherapy in women with breast cancer. J Clin Endocrinol Metab 2004;89:2248-2253.
10.
Shiraishi N, Inomata M, Osawa N, Yasuda K, Adachi Y, Kitano S: Early and late recurrence after gastrectomy for gastric carcinoma. Univariate and multivariate analyses. Cancer 2000;89:255-261.
11.
Kang WM, Meng QB, Yu JC, Ma ZQ, Li ZT: Factors associated with early recurrence after curative surgery for gastric cancer. World J Gastroenterol 2015;21:5934-5940.
12.
Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE: A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab 2008;33:997-1006.
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2017
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