[in Japanese]

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[in Japanese]

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[in Japanese]

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Skeletal muscle mass and circadian rhythm affect the metabolism of 5‐fluorouracil (5‐FU). Reducing the amount of exercise and sleep in patients undergoing chemotherapy can increase the incidence of adverse events ; however, their association with adverse events is unclear. Using a wearable activity meter, we assessed the number of steps and sleep time in patients undergoing chemotherapy. We examined the effects of the number of steps and sleep time on the incidence of neutropenia in patients with colorectal cancer undergoing chemotherapy including 5‐FU. This study included 59 patients. The normal group included 45 patients and the neutropenia group included 14 patients. The shallow sleep time was longer in patients with neutropenia, but no difference was observed in the total sleep time or the total number of steps. Machine learning revealed that the quality and quantity of sleep significantly affect the incidence of neutropenia；however, the number of steps had only a moderate effect. In conclusion, the quantity and quality of sleep can affect the metabolism of 5‐FU and the incidence of neutropenia.

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Background: Sarcopenia has been reported to be associated with short‐and long‐term outcomes in patients with gastric cancer (GC). However, the impact of muscle quality on infectious complications after laparoscopic gastrectomy for GC is unclear. The aim of this study was to investigate the impact of preoperative skeletal muscle quantity and quality on infectious complications in patients undergoing laparoscopic gastrectomy for early gastric cancer.
Methods: This study included 173 early gastric cancer patients who underwent laparoscopic gastrectomy between 2009 and 2018. The relationships among clinical factors, intramuscular adipose tissue content (IMAC) , and postoperative infectious complications were examined retrospectively.
Results: Postoperative infectious complications were observed in 20 patients (11.6％). Independent risk factors for postoperative infectious complications by multivariate analysis were male gender (p＝0.003), a low Prognostic Nutritional Index (p＝0.008), and a high IMAC (p＝0.020). Patients with a high IMAC were older, had a higher body mass index, and a higher prevalence of diabetes mellitus.
Conclusion: Low‐quality skeletal muscle is a risk factor for postoperative infectious complications of laparoscopic gastrectomy. Nutritional support and preoperative rehabilitation to improve the muscle quality were suggested to be useful to prevent postoperative infectious complications.

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