Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study

• Published in: Journal of cancer research and clinical oncology Vol. 142; no. 11; pp. 2347 - 2356
• Main Authors: Huang, Dong-Dong, Chen, Xiao-Xi, Chen, Xi-Yi, Wang, Su-Lin, Shen, Xian, Chen, Xiao-Lei, Yu, Zhen, Zhuang, Cheng-Le
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2016; Springer Nature B.V
• Subjects: Age Factors; Aged; Cancer Research; Cancer surgery; Cohort Studies; Female; Gastrectomy; Gastric cancer; Hematology; Humans; Internal Medicine; Male; Medical prognosis; Medicine; Medicine & Public Health; Older people; Oncology; Original Article – Clinical Oncology; Original – Clinical Oncology; Predictive Value of Tests; Prospective Studies; Sarcopenia; Sarcopenia - mortality; Sarcopenia - pathology; Sarcopenia - physiopathology; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgical outcomes; Sarcopenia; Gastrectomy; Elderly; Mortality; Stomach neoplasms
• ISSN: 0171-5216; 1432-1335; 1432-1335
• DOI: 10.1007/s00432-016-2230-4

Purpose One-year mortality is vital for elderly oncologic patients undergoing surgery. Recent studies have demonstrated that sarcopenia can predict outcomes after major abdominal surgeries, but the association of sarcopenia and 1-year mortality has never been investigated in a prospective study. Methods We conducted a prospective study of elderly patients (≥65 years) who underwent curative gastrectomy for gastric cancer from July 2014 to July 2015. Sarcopenia was determined by the measurements of muscle mass, handgrip strength, and gait speed. Univariate and multivariate analyses were used to identify the risk factors associated with 1-year mortality. Results A total of 173 patients were included, in which 52 (30.1 %) patients were identified as having sarcopenia. Twenty-four (13.9 %) patients died within 1 year of surgery. Multivariate analysis showed that sarcopenia was an independent risk factor for 1-year mortality. Area under the receiver operating characteristic curve demonstrated an increased predictive power for 1-year mortality with the inclusion of sarcopenia, from 0.835 to 0.868. Solely low muscle mass was not predictive of 1-year mortality in the multivariate analysis. Conclusions Sarcopenia is predictive of 1-year mortality in elderly patients undergoing gastric cancer surgery. The measurement of muscle function is important for sarcopenia as a preoperative assessment tool.