Wang Su-Lin, Chen Chen-Bin, Huang Yun-Shi, Ruan Xiao-Jiao, Cheng Jun, Shen Xian, Dong Qian-Tong
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Zhejiang Key Laboratory of Intelligent Cancer Biomarker Discovery and Translation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Eur J Surg Oncol. 2025 Sep;51(9):110229. doi: 10.1016/j.ejso.2025.110229. Epub 2025 Jun 11.
Muscle-specific strength is a newly proposed indicator for assessing muscle quality. Its prognostic value in patients undergoing cancer surgery remains unclear. This study aims to evaluate the impact of low muscle-specific strength on short- and long-term outcomes in patients with resectable gastric cancer.
Patient data were prospectively collected from 2013 to 2019 for individuals diagnosed with gastric cancer. Muscle-specific strength was determined by calculating the ratio of grip strength to skeletal muscle area. Reference values for low muscle-specific strength were calculated using optimal stratification with X-tile software. Survival outcomes were analyzed using Kaplan-Meier survival curves and multivariate Cox proportional hazards models.
A total of 1404 patients were included, comprising 1030 males (73.4 %) and 374 females (26.6 %) with a median age of 66 years. Low muscle-specific strength was identified as an independent risk factor for severe postoperative complications (OR = 2.026, 95 % CI = 1.115-3.684, P = 0.021) and overall survival (HR = 1.385, 95 % CI = 1.072-1.789, P = 0.013). In the subgroup analysis, low muscle-specific strength emerged as an independent risk factor for both postoperative severe complications (HR = 1.938, 95 % CI = 1.024-3.668, P = 0.042) and overall survival (HR = 1.359, 95 % CI = 1.017-1.816, P = 0.038) in males, but not in females. A combination of low muscle strength, low muscle-specific strength, and low muscle mass exhibited a better prognostic value for mortality risk than any two-factor combination or individual indicator.
Muscle-specific strength may serve as a reliable alternative to traditional sarcopenia criteria in predicting the prognosis of surgical oncology patients. The integration of multiple muscle-related indicators can further enhance risk stratification for adverse outcomes.
肌肉特异性力量是一种新提出的评估肌肉质量的指标。其在癌症手术患者中的预后价值尚不清楚。本研究旨在评估低肌肉特异性力量对可切除胃癌患者短期和长期预后的影响。
前瞻性收集2013年至2019年诊断为胃癌的患者数据。通过计算握力与骨骼肌面积的比值来确定肌肉特异性力量。使用X-tile软件进行最佳分层计算低肌肉特异性力量的参考值。使用Kaplan-Meier生存曲线和多变量Cox比例风险模型分析生存结果。
共纳入1404例患者，其中男性1030例（73.4%），女性374例（26.6%），中位年龄66岁。低肌肉特异性力量被确定为术后严重并发症（OR = 2.026，95%CI = 1.115 - 3.684，P = 0.021）和总生存（HR = 1.385，95%CI = 1.072 - 1.789，P = 0.013）的独立危险因素。在亚组分析中，低肌肉特异性力量在男性中是术后严重并发症（HR = 1.938，95%CI = 1.024 - 3.668，P = 0.042）和总生存（HR = 1.359，95%CI = 1.017 - 1.816，P = 0.038）的独立危险因素，但在女性中不是。低肌肉力量、低肌肉特异性力量和低肌肉量的组合在预测死亡风险方面比任何双因素组合或单个指标具有更好的预后价值。
肌肉特异性力量在预测外科肿瘤患者预后方面可能是传统肌肉减少症标准的可靠替代指标。多种肌肉相关指标的整合可进一步增强不良结局的风险分层。
