• Ryota Matsui, Noriyuki Inaki, and Toshikatsu Tsuji.
• Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Department of Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
• Nutrition. 2022 May 1; 97: 111619.

ObjectivesThe aim of this study was to examine the effects of a decrease in visceral adipose tissue on the long-term outcomes of patients with gastric cancer after surgery.MethodsThis single-institution, retrospective study included a cohort of 485 patients who underwent gastrectomy for P-T2 (MP; or a more advanced gastric cancer) from April 2008 to April 2018. The preoperative visceral adipose tissue area and the skeletal muscle area were measured on computed tomography images. The areas were divided by height (m2) to obtain the visceral adipose tissue index (VAI) and skeletal muscle mass index (SMI).ResultsOf the 485 patients, 243 (50.1%) were in the low-VAI group and 242 (49.9%) were in the high-VAI group. For overall survival, the low-VAI group, compared with the high-VAI group, had a significantly poorer prognosis (P < 0.001). Multivariate analysis indicated that both low VAI (hazard ratio [HR], 1.666; 95% confidence interval [CI], 1.127-2.461; P = 0.010) and low SMI (HR, 1.467; 95% CI, 1.057-2.035; P = 0.022) were independent prognostic factors.ConclusionBoth loss of preoperative skeletal muscle mass and a decrease in visceral adipose tissue have an effect on the long-term outcomes of advanced gastric cancer.Copyright © 2022 Elsevier Inc. All rights reserved.

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