Sarcopenia as a novel prognostic factor in the patients of primary localized gastrointestinal stromal tumor

• Published in: BMC cancer Vol. 22; no. 1; p. 179
• Main Authors: Song, He, Xiao, Xianhao, Liu, Gang, Zhou, Jianping
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.02.2022; BioMed Central; BMC
• Subjects: Body mass index; Complications and side effects; Computed tomography; Female; Gastrointestinal cancer; Gastrointestinal Neoplasms - complications; Gastrointestinal Neoplasms - mortality; Gastrointestinal stromal tumor; Gastrointestinal Stromal Tumors - complications; Gastrointestinal Stromal Tumors - mortality; Gastrointestinal tumors; Health aspects; Humans; Male; Medical prognosis; Middle Aged; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - pathology; Muscles; Musculoskeletal system; Nomograms; Patients; Postoperative Period; Prognosis; Retrospective Studies; Risk factors; Sarcopenia; Sarcopenia - diagnostic imaging; Sarcopenia - etiology; Sarcopenia - mortality; Skeletal muscle; Skeletal muscle index; Software; Survival; Tomography; Tomography, X-Ray Computed - statistics & numerical data; Tumors; Vertebrae; China; Skeletal muscle index; Sarcopenia; Survival; Gastrointestinal stromal tumor
• DOI: 10.1186/s12885-022-09278-w
• ISSN: 1471-2407

Sarcopenia predicts poor prognosis of a variety of gastrointestinal malignancies. However, there is a lack of study on the association between skeletal muscle index (SMI) and the prognosis of gastrointestinal stromal tumor (GIST). The aim of this study is to develop a novel nomogram based on sarcopenia for GIST patients to predict overall survival (OS). SMI was measured by computed tomography scan of 107 patients who underwent resection for primary localized gastrointestinal stromal tumor (GIST). Sarcopenia was defined by cutoff values for SMI as 40.1 cm /m and 39.8 cm /m using optimum stratification for males and females respectively. Factors were included in the nomogram were specified by univariate and multiple Cox proportional hazard analysis. Concordance index (C-index) and calibration curves were conducted to measure the discrimination and accuracy of the nomogram. The utility of the nomogram was assessed by the decision curve analysis (DCA). Twenty-eight (26.2%) of 107 patients were sarcopenic. Sarcopenia was correlated significantly with body mass index, albumin, female sex, resection style, mitotic index, rupture status, survival. Sarcopenia was significantly related to decreased overall survival (p = 0.003).The nomogram including sarcopenia status, resection style and mitotic index had an excellent discrimination with C-index 0.794. The calibration curves represented a good accordance between the actual observation and nomogram prediction for overall survival. Decision curve analysis illustrated that the nomogram was helpful in clinic. We developed a nomogram based on sarcopenia to predict overall survival after resection of GISTs which is an effective and favorable prognostication tool.