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Purpose <p>To clarify the association between visceral fat and the prognosis in patients with unresectable or recurrent gastric cancer following chemotherapy.</p> Methods <p>A total of 118 patients were retrospectively analyzed and categorized into high- and low-visceral fat index (VFI) groups, using a cutoff value of 46.5 cm<sup>2</sup>/m<sup>2</sup>. Propensity score matching was performed to adjust for background factors. The overall survival (OS) and progression-free survival (PFS) were compared between the groups. In addition, the objective response rate (ORR), disease control rate (DCR), nutritional indicators, chemotherapy duration, transition rates, and adverse effects were analyzed. A multivariate analysis was used to identify the predictors of the OS and PFS.</p> Results <p>After matching, the high-VFI group demonstrated a significantly better OS and PFS than the low-VFI group. The ORR (40.6% vs. 15.6%, <i>P</i> = 0.026) and DCR (90.6% vs. 67.7%, <i>P</i> = 0.025) were significantly higher in the high-VFI group than the low-VFI group. The high-VFI group also showed a better nutritional status, longer S-1-based chemotherapy duration, higher transition rates to second-/third-line therapy, and fewer adverse events than the low-VFI group. A multivariate analysis identified VFI loss and target lesions (peritoneal and liver) as independent predictors of the OS, whereas VFI loss and target/non-target lesions were predictors of the PFS.</p> Conclusion <p>A high VFI was associated with an improved survival in patients with unresectable or recurrent gastric cancer by enhancing chemotherapy tolerance, reducing adverse events, and increasing the ORR and DCR.</p>

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Association of visceral fat with unresectable/recurrent gastric cancer patients following chemotherapy: a propensity score-matched analysis

  • 期刊论文

  • 发表日期：

    2025年7月2日

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  • Ryohei Nishiguchi,
  • Takeshi Shimakawa,
  • Shinichi Asaka,
  • Masako Ogawa,
  • Masano Sagawa,
  • Kotaro Kuhara,
  • Takebumi Usui,
  • Hajime Yokomizo,
  • Shunichi Shiozawa

摘要

Purpose

To clarify the association between visceral fat and the prognosis in patients with unresectable or recurrent gastric cancer following chemotherapy.

Methods

A total of 118 patients were retrospectively analyzed and categorized into high- and low-visceral fat index (VFI) groups, using a cutoff value of 46.5 cm2/m2. Propensity score matching was performed to adjust for background factors. The overall survival (OS) and progression-free survival (PFS) were compared between the groups. In addition, the objective response rate (ORR), disease control rate (DCR), nutritional indicators, chemotherapy duration, transition rates, and adverse effects were analyzed. A multivariate analysis was used to identify the predictors of the OS and PFS.

Results

After matching, the high-VFI group demonstrated a significantly better OS and PFS than the low-VFI group. The ORR (40.6% vs. 15.6%, P = 0.026) and DCR (90.6% vs. 67.7%, P = 0.025) were significantly higher in the high-VFI group than the low-VFI group. The high-VFI group also showed a better nutritional status, longer S-1-based chemotherapy duration, higher transition rates to second-/third-line therapy, and fewer adverse events than the low-VFI group. A multivariate analysis identified VFI loss and target lesions (peritoneal and liver) as independent predictors of the OS, whereas VFI loss and target/non-target lesions were predictors of the PFS.

Conclusion

A high VFI was associated with an improved survival in patients with unresectable or recurrent gastric cancer by enhancing chemotherapy tolerance, reducing adverse events, and increasing the ORR and DCR.