Yamagishi Shunsuke, Okamura Yukiyasu, Kang Woodae, Shindate Masataka, Kochi Mitsugu, Mitsuka Yusuke, Watabe Megumu, Yoshida Nao, Ikarashi Masahito, Yamazaki Shintaro, Aramaki Osamu, Nakayama Hisashi, Moriguchi Masamichi, Higaki Tokio, Yamashita Hiroharu
Division of Digestive Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan,
Division of Digestive Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Dig Surg. 2023;40(5):143-152. doi: 10.1159/000531797. Epub 2023 Aug 1.
Several studies have indicated that sarcopenia affects the short- and long-term outcomes of cancer patients, including those with gastric cancer. In recent years, sarcopenic obesity and its effects have been reported in cancer patients. This study aimed to evaluate the impact of sarcopenic obesity on postoperative complications in patients with gastric cancer undergoing gastrectomy.
This single-center, retrospective study included 155 patients who underwent curative gastrectomy for gastric cancer from January 2015 to July 2021. Sarcopenia was defined by the psoas muscle index (<6.36 cm2/m2 in men and <3.92 cm2/m2 in women), which measures the iliopsoas muscle area at the lumbar L3 level using computed tomography. Obesity was defined by body mass index (≥25). Patients with both sarcopenia and obesity were defined as the sarcopenic obesity group and others as the non-sarcopenic obesity group. Severe postoperative complications were defined as Clavien-Dindo classification grade IIIa or higher.
Of the 155 patients, 26 (16.8%) had sarcopenic obesity. The incidence of severe postoperative complications was significantly higher in the sarcopenic obesity group (30.8% vs. 10.9%; p = 0.014). Multivariate analysis indicated that sarcopenic obesity was an independent risk factor for severe postoperative complications (odds ratio, 3.950; 95% confidence interval, 1.390-11.200; p = 0.010).
Sarcopenic obesity is an independent risk factor for severe postoperative complications.
多项研究表明，肌肉减少症会影响癌症患者的短期和长期预后，包括胃癌患者。近年来，已有报道称癌症患者存在肌肉减少性肥胖及其影响。本研究旨在评估肌肉减少性肥胖对接受胃切除术的胃癌患者术后并发症的影响。
本单中心回顾性研究纳入了2015年1月至2021年7月期间因胃癌接受根治性胃切除术的155例患者。肌肉减少症的定义为腰大肌指数（男性<6.36 cm²/m²，女性<3.92 cm²/m²），该指数通过计算机断层扫描测量腰椎L3水平的髂腰肌面积。肥胖的定义为体重指数（≥25）。同时患有肌肉减少症和肥胖症的患者被定义为肌肉减少性肥胖组，其他患者为非肌肉减少性肥胖组。严重术后并发症的定义为Clavien-Dindo分类IIIa级或更高。
155例患者中，26例（16.8%）患有肌肉减少性肥胖。肌肉减少性肥胖组严重术后并发症的发生率显著更高（30.8%对10.9%；p = 0.014）。多因素分析表明肌肉减少性肥胖是严重术后并发症的独立危险因素（比值比，3.950；95%置信区间，1.390 - 11.200；p = 0.010）。
肌肉减少性肥胖是严重术后并发症的独立危险因素。
