• Nutrition · Jan 2025

    Application of computed tomography body composition in patients with locally progressive gastric cancer undergoing radical surgery combined with prophylactic hyperthermic intraperitoneal chemotherapy.

    • Wenzhi Wu, Ruiqing Liu, Dongsheng Wang, Yu Li, Wenchang Yang, Zheng Ma, Liang Wang, Simeng Zhang, Zongsheng Sun, Maoshen Zhang, and Xianxiang Zhang.
    • Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China; Qingdao Medical College, Qingdao University, Qingdao, Shandong Province, China.
    • Nutrition. 2025 Jan 7; 132: 112686112686.

    ObjectivesRadical resection combined with prophylactic hyperthermic intraperitoneal chemotherapy (p-HIPEC) is a promising treatment for locally advanced gastric cancer (LAGC), though factors influencing its long-term benefits remain unclear. This study aimed to assess the impact of computed tomography (CT)-based body composition parameters on survival in patients undergoing this combination treatment, exploring nutritional factors affecting long-term survival and developing a prognostic model.MethodsWe retrospectively analyzed clinical and CT data from 230 patients with LAGC who underwent radical resection with p-HIPEC between January 2017 and December 2020. Cox regression and Kaplan-Meier analysis were used to identify independent risk factors, and nomograms were constructed based on significant predictors. The models' accuracy was evaluated using receiver operating characteristic (ROC) curves and calibration plots.ResultsOf the 230 patients, the 3-year survival rate was 56.1%, with a median overall survival of 49.7 months. Multivariate analysis identified sarcopenia (hazard ratio [HR], 3.078; p < 0.001), low subcutaneous adipose tissue index (HR, 1.739; p = 0.002), high visceral-to-subcutaneous adipose tissue ratio (HR, 1.746; p = 0.002), pT stage (p < 0.001), pN stage (N3: p = 0.004; N2: p = 0.049), and vascular invasion (p < 0.001) as independent risk factors for poor survival. Nomograms incorporating body composition and tumor features predicted 1-, 3-, and 5-year overall survival with high accuracy (AUC >0.7).ConclusionsBody composition and tumor characteristics are independent predictors of overall survival in LAGC patients. Nomograms integrating these factors provide reliable prognostic predictions.Copyright © 2025 Elsevier Inc. All rights reserved.

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