IGCC22-ABS-1302
PROGNOSTIC SIGNIFICANCE OF NEOADJUVANT TREATMENT INDUCED SARCOPENIA IN PATIENTS WITH GASTRIC CANCER
Elif Şenocak T*a1ş,çLıeyla Ozer1, Arda Ulaş Mutl2u, Metincan Erkaya2, Mirac Ajredini3, Ibrahim Yildiz1, Ahmet L. Güne4r
, Mustafa Bozkurt1, Ali Arıcan1, ÖzlemEr5, Erman Aytac6
1Medical Oncology, Acıbadem Atakent Hospital, 2Medical Faculty, Acıbadem MAA University, Istanbul, 3Medical Faculty, Trakya University, Trakya, 4Nuclear Medicine, 5Medical Oncology, Acıbadem Maslak Hospital, 6General Surgery, Acıbadem Atakent Hospital, Istanbul, Turkey

Objectives: Neoadjuvant treatment has become a standardized protocol in locally advanced gastric cancer (GC). Sarcopenia is a frequently seen problem associated with the toxic effects of neoadjuvant therapy and causes more complications postoperatively. This study aims to compare the effect of different neoadjuvant protocols on sarcopenia. Methods: GC patients diagnosed with locally advanced disease between 2014-2020 were analyzed retrospectively. The patients who received neoadjuvant treatment were eligible. The total cross-sectional skeletal muscle area at the 3rd lumbar vertebra on computed tomography images − 30 to 150 HU for the muscle compart) was measured using Leonardo volume analyzer. For normalization, the skeletal muscle area was divided by the square of the patient's height (cm2/m2). Sarcopenia cut-off values for males and females were 69.7 and 54.2 cm2/m2, respectively. Kaplan-Meier, log rank and independent T-test were used for analysis.

Results: The clinicopathological data of 26 patients were evaluated. The mean age was 58.9 and 53.8% were male. The number of patients in FLOT (5-fluouracil, oxaliplatin and docetaxel) and DCF (doxetacel, cisplatin, 5-fluouracil) arm were equal. There was not any difference in demographic characteristics and treatment response between two groups. The decrease in muscle mass of FLOT group was 1.10%. An increase in muscle mass was seen, which is 0.13% in DCF group. Both results were not significant (p=0.761). None of the patients became sarcopenic. The albumin levels of patients in FLOT and DCF group decreased 10.3% and 21.3%, respectively (p=0.133). No significant relation was found with overall survival for both groups (p=0.407).

Conclusions: Limited number of patients included, and highly standardized supportive care measures might have contributed to absence of sarcopenia in our study. Even though the decrease in albumin levels were more evident in DCF group, there seems to be no difference regarding induction of sarcopenia among the two neoadjuvant regimens.