Effect of visceral obesity on outcomes of fluorescence-guided lymphadenectomy during laparoscopic gastrectomy for gastric cancer:Post hoc analysis of a randomized phase 3 trial  

作　　者：Yihui Tang Zening Huang Xingqi Zhang Ping Li Jianwei Xie Jiabin Wang Qiyue Chen Longlong Cao Mi Lin Ruhong Tu Guangtan Lin Hualong Zheng Qing Zhong Juli Lin Zihao Yao Dong Wu Chaohui Zheng Jianxian Lin Changming Huang 

机构地区：[1]Department of Gastric Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China [2]Department of General Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China [3]Fujian Province Minimally Invasive Medical Center,Fuzhou 350001,China [4]Key Laboratory of Gastrointestinal Cancer(Fujian Medical University),Ministry of Education,Fuzhou 350108,China

出　　处：《Chinese Journal of Cancer Research》2024年第5期503-516,共14页中国癌症研究（英文版）

基　　金：supported by the Construction Funds for“High-level Hospitals and Clinical Specialties”of Fujian Province(No.[2021]76)。

摘　　要：Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy vs.conventional laparoscopic radical gastrectomy from November 2018 to July 2019.The VFA was calculated based on preoperative computed tomography images.Short-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the VFA.The ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA patients.Regardless of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity.

关 键 词：Gastric cancer laparoscopic gastrectomy indocyanine green visceral obesity lymph node dissection survival 

分 类 号：R735.2[医药卫生—肿瘤]