Prognostic Significance of Preoperative CT-Determined Sarcopenia in Patients with Gastric Cancer Receiving Surgery

10.6966/EDMJ.202209_9(3).0001

Kuen-Jang Tsai；Kuan-Tso Chen；Chao-Ming Hung；Yaw-Sen Chen；Kun-Chou Hsieh；Pei-Min Hsieh；Chin-Chuan Tsai；Yuan-Her Lin；Hao-Chun Chen；Yu-Hsien Kuo；Chao-Sung Chang

sarcopenia ； gastric cancer ； skeletal muscle index ； skeletal muscle density

E-Da Medical Journal

9卷3期（2022 / 09 / 01）

1 - 13+ap1-3

英文

Objective: Sarcopenia is a prognostic factor in the prediction of long-term outcomes of various cancers. This study investigates the impact of preoperative computed tomography (CT)-determined sarcopenia on gastric cancer patients who underwent curative-intent surgical resection. Methods: This study retrospectively reviewed one hundred eighty-nine surgical patients with gastric adenocarcinoma at E-Da Hospital and E-Da Cancer Hospital from January 2008 to December 2017. The skeletal muscle index (SMI) and skeletal muscle density (SMD) were analyzed on the preoperative CT images. The sex-specific lowest quartile was the cut-off point for sarcopenia. Results: SMI and SMD were evaluated as prognostic factors. In the Kaplan-Meier curve analysis, survival (log-rank test p = 0.022 for SMI and p = 0.028 for SMD) was significantly longer in nonsarcopenic than sarcopenic patients. Multivariate analysis demonstrated that hypoalbuminemia, disease stage, and SMD-sarcopenia showed significant negative prognostic impacts on overall survival. Meanwhile, SMI-sarcopenia, hypoalbuminemia, open total gastrectomy and high grade post-operative complications (i.e., Clavien-Dindo classification grade ≥3) were independent predictive factors for postoperative hospital stays longer than 14 days. Conclusions: SMI-and SMD-sarcopenia correlated to poor survival rates in our patients. SMD-sarcopenia was an independent prognostic factor in the whole patient group. SMI-sarcopenia was a predictive factor for hospitalization longer than 14 days in all patients. There was no association either between sarcopenia and progression-free survival or between sarcopenia and severe postoperative complications.