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

Abstract

Background: The relationship between sarcopenia and 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. Methods: This study retrospectively collected data of 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 were used to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results: In this study, there were 59 patients (42.8%) with sarcopenia. Among the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, of serious postoperative complications 0% and 3.7%, of postoperative surgical complications 13.6% and 15.2%, of postoperative systemic complications 20.3% and 15.2% (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). Multivariate analysis showed that sarcopenia was related to long-term prognoses of g-NENs patients. A stratified analysis based on 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, multivariate analysis showed that sarcopenia was an independent risk factor for gMANEC patients (p<0.05).Conclusion: Sarcopenia is not related to short-term prognoses of g-NENs patients. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.