{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:06:31Z","timestamp":1793862391304,"version":"4.6.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia or skeletal muscle depletion is a poor prognostic factor for gastric cancer (GC). However, existing cutoff values of skeletal muscle index (SMI) for defining sarcopenia have been found to have limitations when clinically applied. This study aimed to determine the optimal cutoff for SMI to predict severe toxicities of chemotherapy and overall survival (OS) in patients with advanced GC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with metastatic gastric adenocarcinoma who received first-line palliative chemotherapy between January 2014 and December 2021 at Queen Mary Hospital, Hong Kong, were included in this study. The SMI was determined via a pre-chemotherapy computed tomography scan. Optimal cutoff points of SMI were identified by recursive partitioning analysis. Univariate and multivariate analyses evaluating risk factors of severe chemotherapy toxicities and OS were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 158 patients (male: 108 (68.4%), median age: 65.3) were included. The SMI cutoff to define low SMI was \u226433 cm2\/m2 for males and \u226428 cm2\/m2 for females; 30 patients (19.0%) had low SMI. Patients with low SMI had a higher incidence of hematological toxicities (63.3% vs 32.0%, P\u2005=\u2005.001) and non-hematological toxicities (66.7% vs 36.7%, P\u2005=\u2005.003). Multivariable analysis indicated that low SMI and low serum albumin (\u226428 g\/L) were independent predictive factors of hematological toxicity, while low SMI and neutrophil-lymphocyte ratio \u22655 were predictive factors of non-hematological toxicity. Moreover, patients with low SMI had a significantly shorter OS (P\u2005=\u2005.011), lower response rate to chemotherapy (P\u2005=\u2005.045), and lower utilization of subsequent lines of treatment (P\u2005&amp;lt;\u2005.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using pre-chemotherapy SMI cutoff (\u226433 cm2\/m2 for males and 28 cm2\/m2 for females) one can identify individuals with a higher risk of severe chemotherapy toxicities and worse prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyae123","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T01:01:04Z","timestamp":1715821264000},"page":"e1272-e1279","source":"Crossref","is-referenced-by-count":22,"title":["Association of sarcopenia with severe chemotherapy toxicities and survival in patients with advanced gastric cancer"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-9273","authenticated-orcid":false,"given":"Wing-Lok","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Kwan Bryan","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emina Edith","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Yu","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka-On","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Yu-Hong","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Hang Keith","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Queen Elizabeth Hospital , Jordan ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Kwong","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong , Pokfulam ,","place":["Hong 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