Preoperative Cachexia Index Predicts Overall Survival Following Curative Resection for Remnant Gastric Cancer

Area of Science:

• Oncology
• Gastroenterology
• Biomarkers

Background:

• Remnant gastric cancer (RGC) presents a significant clinical challenge.
• Prognostic biomarkers for host vulnerability in RGC are needed.
• The cachexia index (CXI) shows promise but its role in RGC is unclear.

Purpose of the Study:

• To evaluate the prognostic value of preoperative cachexia index (CXI) in patients with remnant gastric cancer (RGC).
• To determine if CXI can predict overall survival (OS) and disease-specific survival (DSS) in RGC patients undergoing curative resection.

Main Methods:

• Retrospective analysis of 51 RGC patients who underwent curative resection (2004-2020).
• Sex-specific CXI cutoff values determined by ROC analysis for 5-year OS.
• OS and DSS assessed using Kaplan-Meier and Cox regression models.

Main Results:

• Low CXI was independently associated with poorer overall survival (OS) (HR=5.284, p=0.026).
• CXI did not significantly correlate with disease-specific survival (DSS).
• Non-cancer-related deaths were more frequent in the low-CXI group.

Conclusions:

• Low preoperative CXI is an independent predictor of poor OS in RGC patients.
• CXI may reflect host-related vulnerability rather than tumor aggressiveness.
• CXI can be a valuable biomarker for perioperative risk stratification in RGC.