Anthropometric and bioimpedansometric predictors of postoperative complications in patients with gastric and cardioesophageal junction cancers

Abstract

BACKGROUND: Among the most common intra-abdominal complications of surgical treatment of gastric and cardioesophageal junction cancers are acute postoperative pancreatitis and abdominal abscesses.

AIM: Identification and study of anthropometric and bioimpedansometric predictors of the complicated course of the postoperative period in patients with gastric and cardioesophageal junction cancers.

MATERIAL AND METHODS: 250 patients with gastric and cardioesophageal junction cancers, 123 men and 127 women, were examined. All subjects underwent radical surgical treatment. In the postoperative period, postoperative complications were recorded in 40 patients. All subjects underwent anthropometric and bioimpedance examination. Height and body weight, transverse diameter of the chest, width of the shoulders and pelvis, waist and hip circumference, and body morphotype were determined. Bioimpedansometric examination was carried out before surgery and in the postoperative period using a domestic hardware and software complex with determination of the body component composition and the phase angle value. The phase angle of impedance reflected the metabolic rate in the body. The results were statistically processed using descriptive statistics methods. The Shapiro–Francia, Kolmogorov–Smirnov tests, Student's t-test, Mann–Whitney test, and the logistic regression method were used. Differences were considered statistically significant at p <0.05.

RESULTS: Women of the gynecomorphic body type were characterized by a significant decrease in the relative values of active cellular and skeletal muscle mass (p=0.001; p=0.001), and the phase angle value until 12–14 days after surgery (p=0.001). Men of the andromorphic body type were characterized by a significant decrease in the relative values of active cell mass (p=0.001) and the phase angle until 12–14 days after surgery (p=0.001). In women of a gynecomorphic morphotype, the likelihood of postoperative complications was 4 times higher than in women of an andromorphic morphotype (p=0.001). Representatives of the mesomorphic body morphotype of both sexes were characterized by stable bioimpedance measurements during the entire postoperative period.

CONCLUSION: Low values of the phase angle in men and women, as well as the classic gynecomorphic body type in women can be used in oncoabdominal surgery as predictors of a high risk postoperative complications developing in patients with gastric and cardioesophageal junction cancers.

Keywords

gastric cancer / cardioesophageal cancer / risk factors / anthropometry / bioimpedansometry / postoperative complications

References

[1] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. DOI: 10.3322/caac.21492.

[2] Sostoyanie onkologicheskoy pomoshchi naseleniyu Rossii v 2022 godu. (State of oncological care for the population of Russia in 2022.) AD Kaprin, VV Starinskiy, AO Shahzadova, editors. Moscow: MNIOI im. P.A. Gertsena — filial FGBU «NMIC radiologii» Minzdrava Rossii; 2022. 239 р. (In Russ.)

[3] Состояние онкологической помощи населению России в 2022 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России; 2022. 239 с.

[4] Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020;396(10251):635–648. DOI: 10.1016/S0140-6736(20)31288-5.

[5] Belkovecz AV, Kurilovich SA, Reshetnikov OV. Hereditary gastric cancer. Mezhdunarodnyy zhurnal prikladnykh i fundamentalnykh issledovaniy. 2016;(1–4):516–522. (In Russ.) EDN: VOAEZZ.

[6] Белковец А.В, Курилович С.А., Решетников О.В. Наследственный рак желудка (научный обзор). Международный журнал прикладных и фундаментальных исследований. 2016;(1–4):516–522. EDN: VOAEZZ.

[7] Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R. Gastric cancer: Epidemiology, risk factors, classification, genomic characteristics and treatment strategies. Int J Mol Sci. 2020;21(11):4012. DOI: 10.3390/ijms21114012.

[8] FitzGerald R, Smith SM. An overview of helicobacter pylori infection. In: Smith SM, editor. Helicobacter Pylori. Methods in Molecular Biology. Vol. 2283. New York: Humana. DOI: 10.1007/978-1-0716-1302-3_1.

[9] Clarrett DM, Hachem C. Gastroesophageal Reflux Disease (GERD). Mo Med. 2018;115(3):214–218. PMID: 30228725.

[10] Liu AR, He QS, Wu WH, Du JL, Kuo ZC, Xia B, Tang Y, Yun P, Cheung EC, Tang YZ, He YL, Zhang CH, Yuan JQ, Sun G. Body composition and risk of gastric cancer: A population-based prospective cohort study. Cancer Med. 2021;10(6):2164–2174. DOI: 10.1002/cam4.3808.

[11] Tan Z. Recent advances in the surgical treatment of advanced gastric cancer: A review. Med Sci Monit. 2019;25:3537–3541. DOI: 10.12659/MSM.916475.

[12] Akhmetzyanov FS. Ways to solve the issues of surgical treatment of stomach cancer. Kazan Medical Journal. 2017;98(4):485–491. (In Russ.) DOI: 10.17750/KMJ2017-485.

[13] Ахметзянов Ф.Ш. Пути решения проблемы хирургического лечения рака желудка. Казанский медицинский журнал. 2017;98(4):485–491. DOI: 10.17750/KMJ2017-485.

[14] Nagata T, Adachi Y, Taniguchi A, Kimura Y, Iitaka D, Iwata G, Yamaoka N. Prognostic impacts of categorized postoperative complications in surgery for gastric cancer. Asian J Surg. 2023;46(1):451–457. DOI: 10.1016/j.asjsur.2022.05.087.

[15] Makuuchi R, Irino T, Tanizawa Y, Bando E, Kawamura T, Terashima M. Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer. Surg Today. 2019;49(3):187–196. DOI: 10.1007/s00595-018-1726-8.

[16] Latifova LV, Krylov NN. Whether it is possible to prevent acute pancreatitis after radical operations with lymphadenectomy in patients with stomach cancer? Vestnik khirurgicheskoy gastroenterologii. 2010;(4):61–68. (In Russ.) EDN: NBOTIJ.

[17] Латифова Л.В., Крылов Н.Н. Можно ли предупредить острый панкреатит после радикальных операций с лимфаденэктомией по поводу рака желудка? Вестник хирургической гастроэнтерологии. 2010;(4):61–68. EDN: NBOTIJ.

[18] Davydov MI, Stilidi IS, Itin AB, Nikulin MP. Possbilities of surgical of treatment of elderly patients with gastric cancer. Clinical Gerontology. 2005;(6):31–37. (In Russ.) EDN: HQUSRL.

[19] Давыдов М.И., Стилиди И.С., Итин А.Б., Никулин М.П. Возможности хирургического лечения больных раком желудка старческого возраста. Клиническая геронтология. 2005;(6):31–37. EDN: HQUSRL.

[20] Kornyakova AR, Ivanov KM, Samoilov PV, Chemezov SV, Krasnova TA. Risk of development of postoperative cardiovascular complications in patients with esophageal and gastric cardia cancer. Vyatskiy meditsinskiy vestnik. 2020;2(66):4–9. (In Russ.) DOI: 10.24411/2220-7880-2020-10072.

[21] Корнякова А.Р., Иванов К.М., Самойлов П.В., Чемезов С.В., Краснова Т.А. Риск возникновения сердечно-сосудистых осложнений при хирургическом лечении рака пищевода и кардии желудка. Вятский медицинский вестник. 2020;2(66):4–9. DOI: 10.24411/2220-7880-2020-10072.

[22] Clavien PA, Strasberg SM. Severity grading of surgical complications. Ann Surg. 2009;250(2):197–198. DOI: 10.1097/SLA.0b013e3181b6dcab.

[23] Ścisło L, Bodys-Cupak I, Walewska E, Kózka M. Nutritional status indicators as predictors of postoperative complications in the elderly with gastrointestinal cancer. Int J Environ Res Public Health. 2022;19(20):13453. DOI: 10.3390/ijerph192013453.

[24] Chen F, Chi J, Liu Y, Fan L, Hu K. Impact of preoperative sarcopenia on postoperative complications and prognosis of gastric cancer resection: A meta-analysis of cohort studies. Arch Gerontol Geriatr. 2022;98:104534. DOI: 10.1016/j.archger.2021.104534.

[25] Kanda M. Preoperative predictors of postoperative complications after gastric cancer resection. Surg Today. 2020;50(1):3–11. DOI: 10.1007/s00595-019-01877-8.

[26] Sorokovikova TV, Morozov AM, Zhukov SV, Ryzhova TS, Morozova AD, Khorak KI, Belyak MA. The role of non-invasive research methods in modern clinical practice. Modern problems of science and education. 2022;(2):132. (In Russ.) DOI: 10.17513/spno.31502.

[27] Сороковикова Т.В., Морозов А.М., Жуков С.В., Рыжова Т.С., Морозова А.Д., Хорак К.И., Беляк М.А. Роль неинвазивных методов исследования в современной клинической практике. Современные проблемы науки и образования. 2022;(2):132. DOI: 10.17513/spno.31502.

[28] Hemke R, Buckless C, Torriani M. Quantitative imaging of body composition. Semin Musculoskelet Radiol. 2020;24(4):375–385. DOI: 10.1055/s-0040-1708824.

[29] Ward LC, Brantlov S. Bioimpedance basics and phase angle fundamentals. Rev Endocr Metab Disord. 2023;24(3):381–391. DOI: 10.1007/s11154-022-09780-3.

[30] Hui D, Dev R, Pimental L, Park M, Cerana MA, Liu D, Bruera E. Association between multi-frequency phase angle and survival in patients with advanced cancer. J Pain Symptom Manage. 2017;53(3):571–577. DOI: 10.1016/j.jpainsymman.2016.09.016.

[31] Wu H, Ding P, Wu J, Yang P, Tian Y, Zhao Q. Phase angle derived from bioelectrical impedance analysis as a marker for predicting sarcopenia. Front Nutr. 2022;9:1060224. DOI: 10.3389/fnut.2022.1060224.

[32] Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–213. DOI: 10.1097/01.sla.0000133083.54934.ae.

[33] Akhmetzyanov FSh, Gaynanshin RR, Akhmetzyanova FF, Zubkova AR, Baltaeva DA, Khan AM. Early complications of gastrectomy with single-row esophagoenteroanastomosis. Bulletin of Contemporary Clinical Medicine. 2020;13(3):7–14. (In Russ.) DOI: 10.20969/VSKM.2020.13(3).7-14.

[34] Ахметзянов Ф.Ш., Гайнаншин Р.Р., Ахметзянова Ф.Ф., Зубкова А.Р., Балтаева Д.А., Кхан А.М. Ранние осложнения после гастрэктомии с однорядным эзофагоэнтероанастомозом. Вестник современной клинической медицины. 2020;13(3):7–14. DOI: 10.20969/VSKM.2020.13(3).7-14.

[35] Sakibaev KSh, Nikityuk DB, Nikolaev DV, Kozuev KB, Nuruev MK. Experience in the use of bioimpedance measurement to assess the composition of the human body. Bulletin of Medicine and Education. 2021;(2):137–146. (In Russ.) EDN: FIXXIU.

[36] Сакибаев К.Ш., Никитюк Д.Б., Николаев Д.В., Козуев К.Б., Нуруев М.К. Опыт применения биоимпедансометрии для оценки состава тела человека. Вестник медицины и образования. 2021;(2):137–146. EDN: FIXXIU.

RIGHTS & PERMISSIONS

Eco-Vector