PMID- 36501076 OWN - NLM STAT- MEDLINE DCOM- 20221216 LR - 20221221 IS - 2072-6643 (Electronic) IS - 2072-6643 (Linking) VI - 14 IP - 23 DP - 2022 Nov 27 TI - Visceral Adipose Tissue Assessment Enhances the Prognostic Value of GLIM Criteria in Patients with Gastric Cancer Undergoing Radical Gastrectomy after Neoadjuvant Treatment. LID - 10.3390/nu14235047 [doi] LID - 5047 AB - BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) criteria has been recently published for diagnosing malnutrition in adults. However, the validity of the GLIM criteria has not been well-established in patients with gastric cancer (GC) treated with neoadjuvant treatment (NT) followed by radical gastrectomy. The present study aimed to explore the prognostic value of GLIM-defined malnutrition before NT and after NT in GC patients and to investigate whether additional visceral adipose tissue (VAT) assessment could improve the predictive power of the GLIM criteria for NT-related adverse events (AEs) and long-term survival. METHODS: GC patients who underwent radical surgery after NT from June 2016 to June 2020 were enrolled in this study. The cross-sectional areas of total skeletal muscle (TSM) and VAT were measured using computed tomography (CT) before NT and after NT. GLIM-defined malnutrition was diagnosed using the two-step approach, including nutritional risk screening and diagnostic assessment. Low VAT was also added to the diagnosis of malnutrition in this study. The predictive value of these malnutrition diagnoses for NT-related AEs, and long-term survival was evaluated in GC patients. RESULTS: A total of 182 GC patients were included in this study, of which 66 (36.3%) patients before NT and 55 (30.2%) patients after NT were diagnosed with GLIM-defined malnutrition, respectively. In addition to GLIM-defined malnutrition, 54 (29.7%) patients had additional low VAT before NT, and 39 (21.4%) patients had additional low VAT after NT. GLIM-defined malnutrition alone before NT was not associated with NT-related AEs in GC patients. The addition of low VAT to GLIM-defined malnutrition led to a significant predictive value for NT-related AEs. Furthermore, GLIM-defined malnutrition before NT and after NT were both identified as independent risk factors for overall survival (OS) and disease-free survival (DFS). The combination of low VAT and GLIM-defined malnutrition showed a higher hazard ratio for the prediction of OS and DFS both before NT and after NT. CONCLUSIONS: The addition of VAT assessment using CT improved the predictive value of GLIM-defined malnutrition for NT-related AEs and long-term survival in GC patients treated with NT followed by radical gastrectomy, which further supports the prognostic importance of assessing adipose tissue simultaneously during the routine nutritional assessment in patients with cancer. FAU - Zhang, Yingjing AU - Zhang Y AUID- ORCID: 0000-0002-5584-7925 AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Jiang, Lin AU - Jiang L AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Su, Pengfei AU - Su P AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Yu, Tian AU - Yu T AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Ma, Zhiqiang AU - Ma Z AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Kang, Weiming AU - Kang W AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Liu, Yuqin AU - Liu Y AD - Department of Pathology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Jin, Zhengyu AU - Jin Z AD - Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. FAU - Yu, Jianchun AU - Yu J AUID- ORCID: 0000-0002-8250-7475 AD - Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. LA - eng GR - No. 2020-I2M-C&T-B-017/CAMS Innovation Fund for Medical Sciences/ GR - D171100006517002, D171100006517004/Beijing Municipal Science and Technology Commission/ PT - Journal Article DEP - 20221127 PL - Switzerland TA - Nutrients JT - Nutrients JID - 101521595 SB - IM MH - Adult MH - Humans MH - *Stomach Neoplasms/surgery MH - Neoadjuvant Therapy/adverse effects MH - Prognosis MH - Intra-Abdominal Fat/diagnostic imaging MH - Gastrectomy/adverse effects MH - *Malnutrition/complications/diagnosis MH - Nutrition Assessment MH - Nutritional Status PMC - PMC9740239 OTO - NOTNLM OT - GLIM OT - clinical outcomes OT - gastric cancer OT - malnutrition OT - visceral adipose tissue COIS- The authors declare no conflict of interest. EDAT- 2022/12/12 06:00 MHDA- 2022/12/15 06:00 PMCR- 2022/11/27 CRDT- 2022/12/11 01:31 PHST- 2022/09/11 00:00 [received] PHST- 2022/11/20 00:00 [revised] PHST- 2022/11/24 00:00 [accepted] PHST- 2022/12/11 01:31 [entrez] PHST- 2022/12/12 06:00 [pubmed] PHST- 2022/12/15 06:00 [medline] PHST- 2022/11/27 00:00 [pmc-release] AID - nu14235047 [pii] AID - nutrients-14-05047 [pii] AID - 10.3390/nu14235047 [doi] PST - epublish SO - Nutrients. 2022 Nov 27;14(23):5047. doi: 10.3390/nu14235047.