Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy

• Published in: The Journal of surgical research Vol. 211; pp. 137 - 146
• Main Authors: Zhou, Chong-Jun, Zhang, Feng-Min, Zhang, Fei-Yu, Yu, Zhen, Chen, Xiao-Lei, Shen, Xian, Zhuang, Cheng-Le, Chen, Xiao-Xi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2017
• Subjects: Aged; Aged, 80 and over; Carcinoma - complications; Carcinoma - surgery; Elderly patients; Female; Follow-Up Studies; Gastrectomy; Gastric cancer; Geriatric Assessment; Humans; Logistic Models; Male; Postoperative complications; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Risk Factors; Sarcopenia; Sarcopenia - complications; Sarcopenia - diagnosis; Stomach Neoplasms - complications; Stomach Neoplasms - surgery; Surgery; Sarcopenia; Geriatric assessment; Elderly patients; Gastric cancer; Postoperative complications
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2016.12.014

A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography–assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P < 0.001), compared with nonsarcopenic patients. The multivariate analysis demonstrated that sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P < 0.001) and the Charlson comorbidity index ≥2 (odds ratio: 3.357, 95% CI: 1.144-9.848, P = 0.027) were independent risk factors for postoperative complications. Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer.