Body composition changes in gastric cancer patients during preoperative flot therapy: Preliminary results of an italian cohort study

Riccardo Manfredi, Emilio Bria, Giampaolo Tortora, Antonio Gasbarrini, Maria Cristina Mele, Emanuele Rinninella, Antonia Strippoli, Raffaella Vivolo, Mariantonietta Di Salvatore, Carmelo Pozzo, Marco Cintoni

Research output: Contribution to journalArticle

Abstract

Background: The impact of the new chemotherapy, fluorouracil plus leucovorin, oxali-platin, and docetaxel (FLOT) on body composition in gastric cancer (GC) patients remains un-known. We assessed body composition changes of GC patients receiving the FLOT regimen and their impact on treatment outcomes. Methods: Preoperative pre-and post-FLOT computed tomog-raphy (CT) scans of advanced GC patients were studied. Lumbar skeletal muscle index (SMI) and adipose indices were calculated before and after FLOT. Results: A total of 26 patients were identified between April 2019 and January 2020. Nineteen patients were sarcopenic at diagnosis. The mean BMI decreased (from 24.4 ± 3.7 to 22.6 ± 3.1; p < 0.0001) as well as the SMI (from 48.74 ± 9.76 to 46.52 ± 9.98; p = 0.009) and visceral adipose index (VAI) (from 49.04 ± 31.06 to 41.99 ± 23.91; p = 0.004) during preoperative FLOT therapy. BMI, SMI, and VAI variations were not associated with toxicity, Response Evaluation Criteria in Solid Tumors (RECIST), response, delay and completion of periop-erative FLOT chemotherapy, and the execution of gastrectomy; a decrease of SMI ≥ 5% was associated with a higher Mandard tumor regression grade (p = 0.01). Conclusions: Almost three-quarters (73.1%) of GC patients were sarcopenic at diagnosis. Preoperative FLOT was associated with a further reduction in SMI, BMI, and VAI. These changes were not associated with short-term outcomes.
Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalNutrients
Volume13
DOIs
Publication statusPublished - 2021

Keywords

  • Adipose tissue
  • Body composition
  • FLOT
  • Gastric cancer
  • Toxicity
  • Neoad-juvant chemotherapy
  • Personalized medicine
  • Sarcopenia
  • SMI
  • Muscle mass

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