Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan;
Department of Surgery, Yokohama City University, Yokohama, Japan.
Anticancer Res. 2022 Sep;42(9):4545-4552. doi: 10.21873/anticanres.15957.
BACKGROUND/AIM: Preoperative sarcopenia is associated with various cancers and affects the long-term prognosis of patients. After gastrectomy for gastric cancer, dynamic changes in body composition occur, and sarcopenia becomes more apparent after surgery than before surgery. However, the relationship between sarcopenia in the early postoperative period and long-term survival is not fully understood. The aim of this study was to determine the effects of surgical sarcopenia on long-term outcomes of patents with gastric cancer.
We included 408 patients who underwent curative gastrectomy (distal or total gastrectomy) for gastric cancer at the Kanagawa Cancer Center from December 2013 to November 2017. Sarcopenia was defined using the skeletal muscle index (SMI), using computed tomography (CT) one month after gastrectomy. We compared the long-term outcomes between patients with and without sarcopenia.
The 5-year overall survival (OS) rates were 83.2% and 91.4% in the surgical and non-surgical sarcopenia groups, respectively. The hazard ratio (HR) of surgical sarcopenia for OS was 2.410 (95% confidence interval (CI)=1.321-4.396). In addition, surgical sarcopenia was associated with non-cancer-related deaths and deaths from other cancers.
Patients with surgical sarcopenia after gastrectomy should be carefully monitored not only for gastric cancer recurrence but also for the occurrence of other diseases, including other cancers.
背景/目的：术前肌少症与多种癌症相关，并影响患者的长期预后。胃癌患者行胃切除术后，身体成分会发生动态变化，且术后肌少症比术前更为明显。然而，术后早期肌少症与长期生存之间的关系尚未完全明确。本研究旨在确定手术性肌少症对胃癌患者长期结局的影响。
我们纳入了 2013 年 12 月至 2017 年 11 月在神奈川癌症中心接受胃癌根治性胃切除术（远端或全胃切除术）的 408 例患者。使用术后 1 个月的计算机断层扫描（CT）定义肌少症，即骨骼肌指数（SMI）。我们比较了肌少症患者与非肌少症患者的长期结局。
手术性肌少症组和非手术性肌少症组的 5 年总生存率（OS）分别为 83.2%和 91.4%。手术性肌少症对 OS 的危害比（HR）为 2.410（95%置信区间（CI）=1.321-4.396）。此外，手术性肌少症与非癌症相关死亡和其他癌症相关死亡相关。
胃切除术后发生手术性肌少症的患者不仅应密切监测胃癌复发情况，还应监测包括其他癌症在内的其他疾病的发生情况。
