Effect of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: results from a large, two-institution series

• Published in: BMC cancer Vol. 20; no. 1; p. 1002
• Main Authors: Wang, Jia-Bin, Xue, Zhen, Lu, Jun, He, Qing-Liang, Zheng, Zhi-Fang, Xu, Bin-Bin, Xie, Jian-Wei, Li, Ping, Xu, Yu, Lin, Jian-Xian, Chen, Qi-Yue, Cao, Long-Long, Lin, Mi, Tu, Ru-Hong, Huang, Ze-Ning, Lin, Ju-Li, Huang, Chang-Ming, Zheng, Chao-Hui
• Format: Journal Article
• Language: English
• Published: England BioMed Central 15.10.2020; BMC
• Subjects: Abdomen; Aged; Biomarkers; Chemotherapy; Female; Gastrectomy; Gastrectomy - adverse effects; Gastrectomy - methods; Gastric cancer; Gastric neuroendocrine neoplasms; Humans; Male; Medical prognosis; Metastasis; Multivariate analysis; Musculoskeletal system; Neuroendocrine tumors; Neuroendocrine Tumors - complications; Neuroendocrine Tumors - mortality; Overall survival; Patients; Prognosis; Retrospective Studies; Risk factors; Sarcopenia; Sarcopenia - etiology; Sarcopenia - mortality; Sarcopenia - pathology; Skeletal muscle; Software; Stomach Neoplasms - complications; Stomach Neoplasms - mortality; Surgery; Surgical outcomes; Survival; Survival Analysis; Systemic diseases; Treatment Outcome; Sarcopenia; Gastric neuroendocrine neoplasms; Overall survival; Risk factors
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-020-07506-9

The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9 and 30.4%, incidences of serious postoperative complications were 0 and 3.7%, incidences of postoperative surgical complications were 13.6 and 15.2%, and incidences of postoperative systemic complications were 20.3 and 15.2%, respectively (all p > 0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p = 0.004; RFS: 52.54% vs 68.35%, p = 0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p = 0.007; RFS: 51.43% vs 74.36%, p = 0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p < 0.05). Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.