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

Zhou, Chong‐Jun; Zhang, Fengmin; Zhang, Feiyu; Yu, Zhen; Chen, Xiaolei; Shen, Xian; Zhuang, Cheng‐Le; Chen, Xiaoxi

doi:10.1016/j.jss.2016.12.014

Cited by 67 publications

(86 citation statements)

References 34 publications

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“…Increased postoperative complication rates in patients with sarcopenia likely reflect the poor nutritional status of individuals diagnosed with depleted muscle mass. Similarly to our results, other studies also showed that sarcopenia defined by SMI was associated with greater preoperative weight loss, lower BMI, lower albumin levels and higher nutritional risk defined by NRS‐2002 . Moreover, height‐adjusted muscle mass has been proposed as a new index for nutritional assessment correlating closely with some functional parameters, that is, gait speed, grip strength, leg endurance, and cardiopulmonary endurance .…”

Section: Discussionsupporting

confidence: 88%

“…Increased postoperative complication rates in patients with sarcopenia likely reflect the poor nutritional status of individuals diagnosed with depleted muscle mass. Similarly to our results, other studies also showed that sarcopenia defined by SMI was associated with greater preoperative weight loss, 32 lower BMI,27,33,34 lower albumin levels27,29,33,34 and higher Univariate and multivariate analysis of risk factors for major postoperative complications…”

supporting

confidence: 90%

“…Values used previously to identify GC patients with impaired postoperative outcomes ranged from 32 37 to 52.4 31 for males and 28.6 37 to 41 29 for women. However, these studies used various statistical approaches to estimate the optimum cut-off points, predominantly the most significant P values discriminating survival, 27,28,33,37 or they used values adopted from other studies. 13,29,31,34 Clearly such methods differ from the recommended use of cut-off points at two standard deviations below the mean reference value obtained from normative healthy young adult populations.…”

Section: Sarcopenia and Long-term Survivalmentioning

confidence: 99%

“…summarizes previous reports recruiting more than 100 patients using definitions of sarcopenia based on the CT measurements of the SMI. Generally, most studies reported an increased risk of postoperative morbidity with ORs of 3 to 9 27,28. However, such observations were not uniform, with some studies showing no effects on postoperative outcomes13,29,30 or impaired recovery only for subgroups i.e.…”

mentioning

confidence: 99%

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Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach

Sierżęga

Chrzan

Wiktorowicz

et al. 2019

Journal of Surgical Oncology

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Introduction Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations. Methods Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma between 2012 and 2015 were reviewed to evaluate the impact of sarcopenia. The definition of sarcopenia was based on the lumbar skeletal muscle index (SMI) using cut‐off values formulated by the international consensus definitions of sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women). Results Sixty (43%) of 138 patients were sarcopenic. Sarcopenia was associated with postoperative morbidity (43% vs 23%; P = .011), major postoperative complications (Clavien‐Dindo ≥3a; 36% vs 21%; P = .035), and reoperations (23% vs 9%; P = .020). Patients with sarcopenia also had prolonged postoperative hospital stay (8.0 vs 6.5 days; P = .010). The overall median survival of patients with sarcopenia was significantly lower than those with normal skeletal muscles (11.0 vs 36.7 months; P = .005) and sarcopenia remained an independent prognostic factor with an odds ratio of 1.94 (95% confidence interval, 1.08 to 3.48; P = .026). Conclusion Sarcopenia, defined by SMI, is associated with an increased risk of postoperative morbidity and impaired long‐term survival.

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Section: Discussionsupporting

confidence: 88%

“…Increased postoperative complication rates in patients with sarcopenia likely reflect the poor nutritional status of individuals diagnosed with depleted muscle mass. Similarly to our results, other studies also showed that sarcopenia defined by SMI was associated with greater preoperative weight loss, 32 lower BMI,27,33,34 lower albumin levels27,29,33,34 and higher Univariate and multivariate analysis of risk factors for major postoperative complications…”

supporting

confidence: 90%

Section: Sarcopenia and Long-term Survivalmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach

Sierżęga

Chrzan

Wiktorowicz

et al. 2019

Journal of Surgical Oncology

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“…Frailty, defined as a lack of physiologic reserve resulting in adverse outcomes, has also been recognized as an independent risk factor for inferior outcome in regard to mortality and morbidity in the elderly, those undergoing surgery, and cancer patients (12)(13)(14). The phenotype of physical frailty is associated with decreased muscle mass, and sarcopenia has been associated with poor short and long-term outcomes, even in overweight and obese patients (15)(16)(17)(18). CT imaging has been found to correlate well with other methods of evaluating muscle mass, which is useful as CT imaging is routinely done prior to resection (19).…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia is a predictor of outcomes after lobectomy

et al. 2018

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Background: As screening for lung cancer rises, an increase in the diagnosis of early stage lung cancers is expected. Lobectomy remains the standard treatment, but there are alternatives, consideration of which requires an estimation of the risk of surgery. Sarcopenia, irrespective of body mass index, confers a worse prognosis in many groups of patients including those undergoing surgery. Here we examine the association of muscle mass with outcomes for patients undergoing lobectomy. Methods: Consecutive patients undergoing lobectomy were retrospectively reviewed. Preoperative computed tomography scans were reviewed, and cross-sectional area of the erector spinae muscles and pectoralis muscles was determined and normalized for height. Univariate and multivariate analyses were then done to examine for an association of muscle mass with morbidity and short-and long-term mortality. Results: During the study period, there were 299 lobectomies, 278 of which were done by video assisted thoracoscopic surgery. The average age of the patients was 67.5±10.6 years. Overall complication rate was 52.2%, pneumonia rate was 8.7%, and the 30-day mortality rate was 1.3%. Mean height adjusted-erector spinae muscle cross-sectional area was 10.6±2.6 cm 2 /m 2 , and mean height adjusted-pectoralis muscle cross sectional area was 13.3±3.8 cm 2 /m 2 . The height adjusted cross sectional areas of the erector spinae and pectoralis muscles were not associated with overall complication rate, rate of pneumonia, readmission, or intensive care unit length of stay. The height adjusted-erector spinae muscle cross sectional area was inversely correlated with 30-day mortality risk, odds ratio 0.77 (95% CI, 0.60-0.98, P=0.036). Mean length of stay was 7.0 days (95% CI, 5.5-8.4 days). Multivariate analysis demonstrated a significant inverse association of the height adjusted-erector spinae muscle cross sectional area with length of stay (P=0.019). Conclusions:The height adjusted-erector spinae muscle cross sectional area was significantly associated with 30-day mortality and length of stay in the hospital. Measurement of muscle mass on preoperative computed tomography imaging may have a role to help predict risk of morbidity and mortality prior to lobectomy.

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Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients

Matsui

Inaki

Tsuji

2021

Annals of Gastroent Surgery

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

Cited by 67 publications

References 34 publications

Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach

Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach

Sarcopenia is a predictor of outcomes after lobectomy

Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients

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