Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Nutrition. 2021 Jun;86:111156. doi: 10.1016/j.nut.2021.111156. Epub 2021 Jan 16.
We investigated whether measurement of muscle quantity/quality has additional predictive value for postoperative complications and long-term survival after gastrectomy for gastric cancer in patients with probable sarcopenia, as defined by the new European Working Group on Sarcopenia in Older People 2 consensus.
We conducted a prospective study of patients who underwent a radical gastrectomy for gastric cancer between August 2014 and June 2019. Muscle strength was measured using a handgrip dynamometer. Computed tomography images at the third lumbar vertebra level were used to assess muscle quantity and quality by the measuring cross-sectional muscle area and mean muscle attenuation, respectively. Probable sarcopenia was defined by low muscle strength. Sarcopenia was diagnosed by additional low muscle quantity or quality. Clinical outcomes were obtained by prospective data collection and follow up.
Probable sarcopenia was identified in 419 patients, including 285 patients with sarcopenia. Patients with sarcopenia had a higher incidence of postoperative complications, higher costs, longer length of postoperative hospital stay, and worse overall survival (OS) and disease-free survival (DFS) compared with patients with low muscle strength only. The multivariate logistic analysis showed that sarcopenia and hypoproteinemia were independent risk factors for postoperative complications in patients with probable sarcopenia. Moreover, multivariate Cox analyses showed that sarcopenia remained an independent risk factor for OS and DFS in patients with probable sarcopenia.
The measurement of muscle quantity/quality has additional predictive value for postoperative complications, OS, and DFS after gastrectomy for gastric cancer in patients with probable sarcopenia.
我们研究了在新的欧洲老年人肌少症工作组共识定义的疑似肌少症患者中，测量肌肉量/质是否对胃癌根治性胃切除术后的术后并发症和长期生存具有额外的预测价值。
我们进行了一项前瞻性研究，纳入了 2014 年 8 月至 2019 年 6 月期间接受胃癌根治性胃切除术的患者。使用握力计测量肌肉力量。在第三腰椎水平的计算机断层扫描图像上，分别通过测量横截面积和平均肌肉衰减来评估肌肉量和质量。低肌肉力量定义为疑似肌少症。通过额外的低肌肉量或质量诊断肌少症。通过前瞻性数据收集和随访获得临床结果。
419 例患者中存在疑似肌少症，其中 285 例患者存在肌少症。与仅低肌肉力量的患者相比，肌少症患者术后并发症发生率更高，医疗费用更高，术后住院时间更长，总生存（OS）和无病生存（DFS）更差。多变量逻辑分析显示，肌少症和低蛋白血症是疑似肌少症患者术后并发症的独立危险因素。此外，多变量 Cox 分析显示，在疑似肌少症患者中，肌少症仍然是 OS 和 DFS 的独立危险因素。
在疑似肌少症患者中，测量肌肉量/质对胃癌根治性胃切除术后的术后并发症、OS 和 DFS 具有额外的预测价值。
