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      Prognostic Impact of Hepatic Steatosis Evaluated by CT on Immunotherapy for Gastric Cancer: Associations with Sarcopenia, Systemic Inflammation, and Hormones

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          Abstract

          Introduction: Immune checkpoint inhibitors (ICIs) are expected to improve the prognosis of gastric cancer (GC). Also, hepatic steatosis has been reported to be associated with cancer cachexia and is expected to be a cancer biomarker. The purpose of this study was to evaluate prognostic impact of hepatic steatosis in ICI therapy for GC. Methods: Unresectable or recurrent GC treated with ICIs was investigated. Using unenhanced CT, the liver-to-spleen CT attenuation ratio (LSR) was calculated as a parameter of hepatic steatosis. LSR was compared with the presence of sarcopenia and inflammatory markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). These parameters were also compared with disease-specific survival (DSS) and progression-free survival (PFS). Associations of LSR with insulin-like growth factor 1 (IGF-1) and growth hormone were also evaluated. Results: A total of 70 patients were investigated. LSR of sarcopenia patients was significantly lower than that of non-sarcopenic ones ( p = 0.02). LSR showed significant negative correlations with NLR, PLR, and MLR ( p = 0.003, 0.03, 0.01, respectively). Lower LSR was significantly associated with a higher level of serum IGF-1 ( p = 0.03). In univariate analysis, LSR was significantly correlated with DSS and PFS (both p < 0.0001), and multivariate analysis demonstrated that LSR was the independent prognostic factor for both DSS and PFS (both p = 0.01). ROC analysis demonstrated that LSR >1.263 was a good predictive marker for favorable DSS (>5.3 months) with an AUC of 0.80. Conclusion: Hepatic steatosis can be a promising prognostic biomarker for ICI therapy of GC, associated with sarcopenia and the elevation of inflammatory markers. Our data suggested that GC with steatohepatitis might be less responsive to ICI therapy.

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          Author and article information

          Journal
          OCL
          Oncology
          10.1159/issn.0030-2414
          Oncology
          Oncology
          S. Karger AG
          0030-2414
          1423-0232
          2023
          March 2023
          15 November 2022
          : 101
          : 3
          : 185-192
          Affiliations
          Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
          Author information
          https://orcid.org/0000-0002-1797-5176
          https://orcid.org/0000-0001-8333-2032
          https://orcid.org/0000-0001-7360-9069
          https://orcid.org/0000-0002-6766-5600
          Article
          528005 Oncology 2023;101:185–192
          10.1159/000528005
          36380615
          edd3d578-fff6-4c37-9b4a-6557f835e532
          © 2022 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 01 October 2022
          : 04 November 2022
          Page count
          Figures: 4, Tables: 3, Pages: 8
          Funding
          This study was partly supported by the Cancer Research Funds for Patients and Family.
          Categories
          Clinical Study

          Medicine
          Hepatic steatosis,Immune checkpoint inhibitor,Cancer cachexia,Gastric cancer
          Medicine
          Hepatic steatosis, Immune checkpoint inhibitor, Cancer cachexia, Gastric cancer

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