P349 - LOSS OF SKELETAL MUSCLE MASS DURING TREATMENT IS ASSOCIATED WITH REDUCED OVERALL SURVIVAL IN GASTRIC CANCER PATIENTS UNDERGOING CONVERSION SURGERY

P349

LOSS OF SKELETAL MUSCLE MASS DURING TREATMENT IS ASSOCIATED WITH REDUCED OVERALL SURVIVAL IN GASTRIC CANCER PATIENTS UNDERGOING CONVERSION SURGERY

M. Sandini^1,*, G. Bagnacci¹, V. Ricchiuti¹, I. Gambassi¹, S. Piccioni¹, I. Capitoni¹, M. A. Mazzei¹, D. Marrelli¹, F. Roviello¹

¹University of Siena, Siena, Italy

Rationale: Multimodal approach in the setting of conversion surgery (CS) improved survival of stage IV gastric cancer (GC). The depletion of the lean mass has been associated with impaired outcomes in GC. Aim was to analyze potential variation of body composition during systemic treatment and to evaluate aftermath on resection and survival.

Methods: In this retrospective analysis, we assessed pre-treatment and preoperative body composition of stage IV GC patients who underwent surgical exploration following systemic treatment in the setting of CS, over a 12-year period. Areas of skeletal muscle and adipose tissue were evaluated before chemotherapy and preceeding surgery.

Results: Out of 42 GC patients, 64.3% were male, and 22/42 were Yoshida category 3-4. Surgical interventions included curative resection (23/42 cases), or palliation (19/42).  We observed difference in the distribution of body components according to gender, at diagnosis, with more subcutaneous adipose tissue in males (p<.001) vs. more visceral adipose tissue in females (p=.039). During systemic treatment, increase in total muscle area was observed only in females (deltaTMA 4.8cm² vs. deltaTMA -7cm² in males, p=.048).

Increased TMA during chemotherapy was associated with improved overall survival, with median OS 63 months, vs. 27 months in lean mass loss (p=.042). The protective effect of TMA was confirmed at multivariate analysis (HR 0.98, 95%CI 0.97-0.99; p=.035).

Conclusion: Increased skeletal muscular mass during systemic treatment independently improved the overall survival. Longitudinal evaluation of body composition must be part of routinary work-up of gastric cancer patients in the setting of conversion surgery. Potential effects of nutritional interventions must be evaluated.

Disclosure of Interest: None declared