Impact of sarcopenia on clinical outcomes of patients with stage I gastric cancer after radical gastrectomy: A prospective cohort study

• Published in: European journal of surgical oncology Vol. 48; no. 3; pp. 541 - 547
• Main Authors: Zhang, Feng-Min, Zhang, Xian-Zhong, Zhu, Guang-Lou, Lv, Lu-Qing, Yan, Xia-Lin, Wu, Wen-Xue, Wang, Su-Lin, Chen, Xiao-Lei, Zhuang, Cheng-Le, Yu, Zhen
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2022
• Subjects: Clinical outcomes; Early-stage; Gastrectomy - adverse effects; Gastric cancer; Hand Strength; Humans; Postoperative Complications - etiology; Prognosis; Prospective Studies; Risk Factors; Sarcopenia; Sarcopenia - complications; Sarcopenia - diagnosis; Sarcopenia - epidemiology; Stomach Neoplasms - complications; Stomach Neoplasms - epidemiology; Stomach Neoplasms - surgery; Sarcopenia; Early-stage; Gastric cancer; Clinical outcomes
• ISSN: 0748-7983; 1532-2157; 1532-2157
• DOI: 10.1016/j.ejso.2021.08.021

The relationships between sarcopenia and postoperative outcomes in patients with early-stage gastric cancer who undergo radical gastrectomy is unclear. We aimed to investigate the predictive value of sarcopenia on adverse outcomes for stage I gastric cancer. The clinical data of patients who underwent radical gastrectomy for stage I gastric cancer between July 2013 and May 2019 were prospectively collected. Basic sarcopenia components were measured preoperatively. Univariate and multivariate analyses were conducted to evaluate the risk factors for short- and long-term outcomes. A total of 507 patients with early-stage gastric cancer were included in the study, and 73 (14.4%) patients were diagnosed as sarcopenia. Patients with sarcopenia had significantly higher incidence of postoperative complications (32.9% vs. 17.5%, P = 0.002), longer postoperative hospital stays (13 days vs. 12 days, P < 0.001), higher hospitalization costs (65210 yuan vs. 55197 yuan, P < 0.001) and one-year mortality (8.2% vs. 1.8%, P = 0.002). During the median follow-up time of 38.8 months, 12 (16.4%) patients dead in the sarcopenic group and 25 (5.8%) patients dead in the non-sarcopenic group. Sarcopenia was an independent risk factor for both short- and long-term clinical outcomes. Moreover, we found that low muscle quantity and low handgrip strength mediated the adverse impacts of sarcopenia on postoperative complications while low muscle quality mediated the adverse impacts of sarcopenia on overall survival. Sarcopenia was strongly associated with worse short- and long-term clinical outcomes in patients with stage I gastric cancer who undergo radical gastrectomy. F09FSarcopenia is the only risk factor of complication in early gastric cancer.F09FSarcopenia is one of the independent risk factors of poor oncologic outcome.F09FLow muscle mass and strength mediate the impact of sarcopenia on complication.F09FLow muscle quality mediated the impact of sarcopenia on overall survival.