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Multicenter Study
. 2024 Mar;38(3):1151-1162.
doi: 10.1007/s00464-023-10638-1. Epub 2023 Dec 11.

Effect of sarcopenia on short-term and long-term outcomes of older patients with locally advanced gastric cancer: a multicenter study

Zi-Fang Zheng #  1   2   3   4 , Guang-Tan Lin #  1   2   3 , Qing Zhong #  1   2   3 , Dong Wu #  1   2   3 , Jun Lu  1   2   3 , Jia-Bin Wang  1   2   3 , Qi-Yue Chen  1   2   3 , Jian-Xian Lin  1   2   3 , Long-Long Cao  1   2   3 , Mi Lin  1   2   3 , Shu-Ping Zheng  5 , Jian-Wei Xie  1   2   3 , Chao-Hui Zheng  1   2   3 , Chang-Ming Huang  6   7   8 , Ping Li  9   10   11
Affiliations
Multicenter Study

Effect of sarcopenia on short-term and long-term outcomes of older patients with locally advanced gastric cancer: a multicenter study

Zi-Fang Zheng et al. Surg Endosc. 2024 Mar.

Abstract

Objective: To assess the effect of preoperative sarcopenia on the short-term and long-term outcomes in older patients with locally advanced gastric cancer (LAGC).

Methods: Clinicopathological data of older patients with LAGC who underwent radical surgery were retrospectively analyzed. Sarcopenia was defined as a skeletal muscle index of less than 36.4 cm2/m2 for men and less than 28.4 cm2/m2 for women. Comparing the postoperative complications and survival between sarcopenia and non-sarcopenia groups using multicenter data.

Results: A total of 406 older patients with LAGC were included in the analysis, including 145 (35.7%) with sarcopenia and 261 (64.3%) with non-sarcopenia. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for postoperative complications with CD grade ≥ II (OR 1.616; P < 0.05). Kaplan-Meier survival curve analysis showed that the 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) in the sarcopenia group were lower than those in the non-sarcopenia group (P both < 0.05). Multivariate Cox regression analyses showed that sarcopenia was an independent prognostic factor for 5-year OS and RFS (P both < 0.05). The 5-year recurrence rate in the sarcopenia group was 57.2%, which was significantly higher than that in the non-sarcopenia group (46.4%; P = 0.036). Recurrence pattern analysis showed that the incidence of distant metastases in patients with sarcopenia (42.8%) was significantly higher than non-sarcopenia (31.4%; P = 0.022).

Conclusion: Sarcopenia serves as a valuable predictor of both short-term and long-term outcomes in older patients with LAGC. Therefore, the significance of assessing preoperative nutritional status and implementing thorough postoperative follow-up for older LAGC patients with sarcopenia should be emphasized.

Keywords: Complications; Locally advanced gastric cancer; Older patients; Prognosis; Sarcopenia.

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