Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes

Tegels, Juul J. W.; Vugt, Jeroen L.A. van; Reisinger, Kostan W.; Hulsewé, Karel W. E.; Hoofwijk, A. G. M.; Derikx, Joep P. M.; Stoot, Jan H.M.B.

doi:10.1002/jso.24015

Cited by 130 publications

(140 citation statements)

References 34 publications

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“…The aim of this study was to investigate if sarcopenia impacted outcomes. One third of our patient population was found to be sarcopenic prior to surgery, which is within the range of sarcopenia in gastric cancer patients reported in the literature (12.5-57.7%) (15)(16)(17). There is some controversy surrounding the association between sarcopenia and postoperative complications.…”

Section: Discussionmentioning

confidence: 60%

“…Reports in the literature are varied regarding the impact of sarcopenia on mortality in patients with gastric cancer, however, there is a paucity of data from Western populations (16,17). In this small cohort, there was no significant difference in survival in patients who were never sarcopenic and those who were sarcopenic.…”

Section: Discussionmentioning

confidence: 61%

“…A meta-analysis of 14 studies linking sarcopenic obesity to clinical outcomes in cancer patients concluded that sarcopenic obesity was associated with increased surgical complications (14). This study found similar rates of complications between patients with sarcopenia and sarcopenic obesity, which was higher than non-sarcopenic patients.Reports in the literature are varied regarding the impact of sarcopenia on mortality in patients with gastric cancer, however, there is a paucity of data from Western populations (16,17). In this small cohort, there was no significant difference in survival in patients who were never sarcopenic and those who were sarcopenic.…”

mentioning

confidence: 61%

“…There is some controversy surrounding the association between sarcopenia and postoperative complications. In a study of 152 patients, sarcopenia was not associated with post-operative morbidity or mortality (17). In a large-scale Asian cohort (16).…”

Section: Discussionmentioning

confidence: 99%

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Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Mirkin¹,

Luke²,

Gangi³

et al. 2017

J. Gastrointest. Oncol.

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Background: This study's objective was to evaluate the change in sarcopenia score following neoadjuvant chemotherapy (NAC) and to correlate both sarcopenia and change in score with perioperative outcomes in patients with advanced resected gastric cancer.Methods: Multi-institutional analysis of patients with gastric cancer who underwent NAC and resection from 2000-2015 was performed. Demographic and perioperative data were included. Sarcopenia score was defined as CT measurement of total psoas muscle at L3, stratified by height (m). Sarcopenia was defined as a score <385 mm 2 /m 2 in women and <545 mm 2 /m 2 in men.Results: Of 36 patients, 19% were sarcopenic prior to NAC. Following NAC, 31% were sarcopenic, with 14% developing sarcopenia during NAC. One patient (3%) became non-sarcopenic. There were no significant differences in patient, disease, or surgery characteristics between patients who were sarcopenic vs.not. Patients with sarcopenia were more likely to have post-operative complications (P=0.05). There was no significant difference in hospital stay (P=0.7402) or survival (P=0.2317).Conclusions: A significant number of patients with gastric cancer become sarcopenic during NAC.Although patients with sarcopenia were nearly twice as likely to develop post-operative complications, this did not appear to impact length of stay (LOS) or survival. and strength two standard deviations below that of healthy adults, has been used as a clinically significant marker of biological age, and has been found to be associated with functional impairment, perioperative complications, and decreased survival in patients with nonmalignant conditions (4-6). Changes in body composition on computed topography (CT) imaging occur after neoadjuvant treatment in many cancers, including esophageal and breast cancer (7)(8)(9)(10).This study sought to understand the impact of NAC on sarcopenia and to evaluate whether sarcopenia is correlated with perioperative outcomes in patients with advanced resected gastric cancer. Methods Patient selectionThis was a multi-institutional, retrospective cohort study. Records of patients who underwent NAC and surgery for gastric adenocarcinoma at Penn State Hershey Medical Center and Moffitt Cancer Center from March 2000 to April 2015 were reviewed. Only patients who had both pre-NAC and post-NAC CT or positron emission tomography (PET-CT) scans, were included in final analysis. Outcomes and covariatesPatient characteristics [including age, sex, body mass index (BMI), comorbidities, pre-operative weight], disease characteristics [American Joint Committee on Cancer (AJCC) T and N stage, tumor size, lymph nodes], and treatment characteristics (surgical approach, type of resection, NAC regimen, surgical margins) were retrospectively collected from the electronic medical record. Post-operative complications, hospital length of stay (LOS), and overall survival were the primary outcomes. Surgical complications were classified by the Clavien-Dindo Classification of Surgical Complications Scale, which grades com...

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Mirkin¹,

Luke²,

Gangi³

et al. 2017

J. Gastrointest. Oncol.

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“…Finally, sarcopenia has high prevalence in comorbidities. For instance, the presence of sarcopenia is raised to 58% in patients after a hip fracture surgery or for instance in patients after gastric cancer surgery 29,30 .…”

Section: Prevalence Of Sarcopeniamentioning

confidence: 99%

Public Health issues in hospital management of Sarcopenic patients

Marinaki¹,

Lambrou

2017

JFSF

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Efficacy and Safety of Trifluridine/Tipiracil Treatment in Patients With Metastatic Gastric Cancer Who Had Undergone Gastrectomy

et al. 2020

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IMPORTANCE Trifluridine/tipiracil (FTD/TPI) treatment has shown clinical benefit in patients with pretreated metastatic gastric cancer or gastroesophageal junction cancer (mGC/GEJC). Patients who have undergone gastrectomy constitute a significant proportion of patients with mGC/GEJC. OBJECTIVE To assess the efficacy and safety of FTD/TPI among patients with previously treated mGC/GEJC who had or had not undergone gastrectomy. DESIGN, SETTING, AND PARTICIPANTS This preplanned subgroup analysis of TAGS (TAS-102 Gastric Study), a phase 3, randomized, placebo-controlled, clinical trial included patients with mGC/GEJC who had received at least 2 previous chemotherapy regimens, and was conducted at 110 academic hospitals in 17 countries in

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Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes

Abstract: In this population of gastric cancer surgical patients, the prevalence of sarcopenia was 57.7%, which is high compared to other abdominal surgical oncology populations. However, sarcopenia was not associated with postoperative morbidity or mortality.

Cited by 130 publications

References 34 publications

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Public Health issues in hospital management of Sarcopenic patients

Efficacy and Safety of Trifluridine/Tipiracil Treatment in Patients With Metastatic Gastric Cancer Who Had Undergone Gastrectomy

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