Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya7046110.26442/18151434.2021.1.200715CLINICAL ONCOLOGYКЛИНИЧЕСКАЯ ОНКОЛОГИЯReview ArticleSarcopenia, sarcopenic obesity, myosteatosis as factors of poor prognosis in gastrointestinal tract tumors: reviewСаркопения, саркопеническое ожирение, миостеатоз как факторы неблагоприятного прогноза при опухолях желудочно-кишечного тракта: обзор литературы7597-3600DikovaTatyana S.ДиковаТатьяна Сергеевна
Russian Federation

Student

студентка

dikovatatyanasergeevna@gmail.com8495-8418ZatsepinaAlina Y.ЗацепинаАлина Юрьевна
Russian Federation

Student

студентка

zatsepina.alina@gmail.com1079-8460FedorinovDenis S.ФедориновДенис Сергеевич
Russian Federation

Senior Laboratory Assistant

ст. лаборант каф. онкологии и паллиативной медицины им. акад. А.И. Савицкого

Deni_fe@mail.comhttps://orcid.org/0000-0002-7281-35915385-7889LyadovVladimir K.ЛядовВладимир Константинович
Russian Federation

D. Sci. (Med.), Russian Medical Academy of Continuous Professional Education, Novokuznetsk State Institute for Postgraduate Medical Education – Branch of Russian Medical Academy of Continuous Professional Education, City Clinical Oncology Hospital №1

Доктор мед. наук, доц. каф. онкологии и паллиативной медицины им. акад. А.И. Савицкого ФГБОУ ДПО РМАНПО, зав. каф. онкологии НГИУВ – филиал ФГБОУ ДПО РМАНПО, зав. отд-нием онкологии №4 ГБУЗ «ГКОБ №1»

vlyadov@gmail.comSechenov First Moscow State Medical University (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)Russian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииNovokuznetsk State Institute for Postgraduate Medical Education – branch of Russian Medical Academy of Continuous Professional EducationНовокузнецкий государственный институт усовершенствования врачей – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииCity Clinical Oncological Hospital №1ГБУЗ «Городская клиническая онкологическая больница №1» Департамента здравоохранения г. Москвы190520212311411471005202110052021Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc/4.0https://modernonco.orscience.ru/1815-1434/article/view/70461

Over the past decade, there has been a noticeable increase in the number of publications devoted to the analysis of body composition in the treatment of gastrointestinal malignancies. Sarcopenia (skeletal muscle depletion), sarcopenic obesity and myosteatosis are shown to have a negative impact on the results of surgical and chemotherapeutic treatment of patients with gastrointestinal tumors. The review presents in detail data on clinical value of sarcopenia, sarcopenic obesity and myosteatosis along with methodological aspects of body composition analysis. Different cut-offs and diagnostic criteria exist between “Western” and “Eastern” patient populations which makes any comparison or meta-analysis not possible right now. The review presents data from Russian and foreign studies on the influence of body composition on postoperative outcomes and survival in patients with gastrointestinal tumors. The article also discusses the influence of body composition on dose-limiting toxicity of chemotherapy. We aimed at raising awareness of clinicians regarding the high prevalence of cancer cachexia and, precisely, sarcopenia, sarcopenic obesity and myosteatosis in patients with GI tract tumors. Deeper understanding of these syndromes is the key to developing measures for prevention as well as correcting the treatment of patients with gastrointestinal tumors.

В последние годы наблюдается тенденция к увеличению количества исследований, посвященных анализу влияния состава тела пациента на результаты лечения опухолей органов желудочно-кишечного тракта (ЖКТ). По данным российских и зарубежных авторов саркопения (истощение скелетной мускулатуры), саркопеническое ожирение (СО) и миостеатоз оказывают негативное влияние на результаты хирургического и лекарственного лечения этой группы пациентов. В обзоре подробно освещены как методические аспекты анализа саркопении, СО и миостеатоза, так и накопленные в мировой литературе сведения о клиническом значении вышеуказанных изменений. На наглядных примерах показаны различия между используемыми диагностическими критериями, которые приводят к значительной гетерогенности исследований. Особенно затруднительным представляется сравнительный анализ результатов работ европейских и азиатских исследователей, поскольку пороговые значения дефицита скелетной мускулатуры и ожирения, по-видимому, принципиально различны у пациентов различной этнической принадлежности. Проведен отдельный анализ влияния саркопении, СО и миостеатоза на частоту послеоперационных осложнений и отдаленную выживаемость больных с опухолями ЖКТ. Отдельно рассмотрена связь изменений состава тела с дозолимитирующей токсичностью лекарственной терапии. Повышение осведомленности врачей-клиницистов о высокой распространенности вышеуказанных состояний имеет ключевое значение для разработки мер профилактики, а также коррекции лечения пациентов с опухолями ЖКТ.

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