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Usefulness of the preoperative inflammation-based prognostic score and the ratio of visceral fat area to psoas muscle area on predicting survival for surgically resected adenocarcinoma of the esophagogastric junction

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Abstract

Background

Sarcopenic obesity is associated with gastrointestinal cancer prognosis through systemic inflammation. However, in patients with adenocarcinoma of the esophagogastric junction (AEG), the relationship between the inflammation-based prognostic score (IBPS), muscle loss, visceral fat mass, and prognosis has not been sufficiently evaluated. We investigated the prognostic value of the preoperative IBPS and the visceral fat area ratio to the psoas muscle area (V/P ratio) in patients with AEG undergoing surgery.

Methods

We retrospectively analyzed 92 patients with AEG who underwent surgery. The prognostic value of the preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio, systemic inflammation response index, C-reactive protein-to-albumin ratio, prognostic nutritional index, modified Glasgow Prognostic Score, and V/P ratio at the third lumbar vertebra was investigated using univariate and multivariate survival analyses.

Results

Multivariate analysis revealed that a high pathological stage (p = 0.0065), high PLR (p = 0.0421), and low V/P ratio (p = 0.0053) were independent prognostic factors for poor overall survival (OS). When restricted to patients with body mass index (BMI) ≥ 25 kg/m2, a high V/P ratio was a poor prognostic factor (p = 0.0463) for OS. Conversely, when restricted to patients with BMI < 25 kg/m2, a low V/P ratio was a poor prognostic factor (p = 0.0021) for OS.

Conclusions

Both PLR and V/P ratios may be useful prognostic biomarkers in surgical cases of AEG. V/P ratio and BMI may provide an accurate understanding of the muscle and fat mass’s precise nature and may help predict AEG prognosis.

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Data availability

Data are available on reasonable request. The data are available from the corresponding author, MS, on reasonable request.

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Acknowledgements

The authors thank Editage (https://www.editage.jp) for the English language review.

Funding

The authors did not receive financial support from any funding sources for this study.

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Authors and Affiliations

  1. Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, maebashi-shi, Gunma-ken, 371-8511, Japan

    Shintaro Uchida, Makoto Sohda, Kohei Tateno, Takayoshi Watanabe, Yuta Shibasaki, Nobuhiro Nakazawa, Kengo Kuriyama, Akihiko Sano, Takehiko Yokobori, Makoto Sakai, Hiroomi Ogawa, Ken Shirabe & Hiroshi Saeki

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  1. Shintaro Uchida
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Contributions

SU collected the data, wrote the manuscript, and prepared the figures. KT, TW, YS, NN, KK, AS, TY, MS, HO, KS, and HS revised the manuscript and provided comments regarding the structure and details of the article. All authors have read and approved the final manuscript.

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Correspondence to Makoto Sohda.

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Ethical statement

The study protocol was approved by the Institutional Review Board of Gunma University Hospital (approval no. HS2021-134). The study followed the ethical standards of the Declaration of Helsinki and its subsequent amendments.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later versions. Informed consent was obtained through an opt-out process on the website.

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Uchida, S., Sohda, M., Tateno, K. et al. Usefulness of the preoperative inflammation-based prognostic score and the ratio of visceral fat area to psoas muscle area on predicting survival for surgically resected adenocarcinoma of the esophagogastric junction. Esophagus 21, 157–164 (2024). https://doi.org/10.1007/s10388-023-01034-8

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