Effects of Sarcopenia on Postoperative Outcomes in Patients Who Underwent Gastrectomy for Gastric Cancer

Erkul, Oğuz; Çekiç, Arif Burak; Cansu, Ayşegül; Yıldırım, Reyyan; Güner, Ali

doi:10.1016/j.jss.2021.12.051

Cited by 12 publications

(4 citation statements)

References 40 publications

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“…Long-term mortality risk at 6 months (OR 4.00, 95 per cent c.i. 1.15 to 13.88) 39 and 1 year (OR 4.77, 95 per cent c.i. 1.60 to 14.17) 48 after surgery was higher in sarcopenic compared with non-sarcopenic patients, although these outcomes were reported in only one study each.…”

Section: Resultsmentioning

confidence: 97%

“…An electronic hand-held dynamometer was used to evaluate muscle strength (in kg) in most studies (17 studies), with the remainder not stating the tool that was used. Sex-specific values of less than 26 kg in men and less than 18 kg in women (11 studies) 36–38 , 41 , 42 , 44 , 45 , 50–53 and less than 27 kg in men and less than 16 kg in women (4 studies) 33 , 34 , 39 , 43 were the most frequently used thresholds to indicate low muscle strength. Muscle performance was estimated using either the GS (14 studies) or the Timed ‘Up and Go’ test (1 study) 48 .…”

Section: Resultsmentioning

confidence: 99%

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Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis

et al. 2023

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Background Sarcopenia refers to the progressive age- or pathology-associated loss of skeletal muscle. When measured radiologically as reduced muscle mass, sarcopenia has been shown to independently predict morbidity and mortality after elective abdominal surgery. However, the European Working Group on Sarcopenia in Older People (EWGSOP) recently updated their sarcopenia definition, emphasizing both low muscle ‘strength’ and ‘mass’. The aim of this systematic review and meta-analysis was to determine the prognostic impact of this updated consensus definition of sarcopenia after elective abdominal surgery. Methods MEDLINE, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for studies comparing prognostic outcomes between sarcopenic versus non-sarcopenic adults after elective abdominal surgery from inception to 15 June 2022. The primary outcomes were postoperative morbidity and mortality. Sensitivity analyses adjusting for confounding patient factors were also performed. Methodological quality assessment of studies was performed independently by two authors using the QUality in Prognosis Studies (QUIPS) tool. Results Twenty articles with 5421 patients (1059 sarcopenic and 4362 non-sarcopenic) were included. Sarcopenic patients were at significantly greater risk of incurring postoperative complications, despite adjusted multivariate analysis (adjusted OR 1.56, 95 per cent c.i. 1.39 to 1.76). Sarcopenic patients also had significantly higher rates of in-hospital (OR 7.62, 95 per cent c.i. 2.86 to 20.34), 30-day (OR 3.84, 95 per cent c.i. 1.27 to 11.64), and 90-day (OR 3.73, 95 per cent c.i. 1.19 to 11.70) mortality. Sarcopenia was an independent risk factor for poorer overall survival in multivariate Cox regression analysis (adjusted HR 1.28, 95 per cent c.i. 1.13 to 1.44). Conclusion Consensus-defined sarcopenia provides important prognostic information after elective abdominal surgery and can be appropriately measured in the preoperative setting. Development of targeted exercise-based interventions that minimize sarcopenia may improve outcomes for patients who are undergoing elective abdominal surgery.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis

et al. 2023

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“…Besides, postoperative skeletal muscle mass loss is also related to more chemotherapy modifications like the dose reduction, delay or termination and has been identified as a risk factor for worse prognosis after gastric cancer surgery, which leads to poorer tumor control and worse survival (48). Furthermore, several studies have indicated that sarcopenia is an independent predictor for worse survival of gastric cancer patients and patient with sarcopenia should be treated more positively (66)(67)(68)(69).…”

Section: Figurementioning

confidence: 99%

Prognostic role of pretreatment skeletal muscle index in gastric cancer patients: A meta-analysis

Zhou²,

Liu³

et al. 2023

Pathol. Oncol. Res.

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Background: The association between pretreatment skeletal muscle index (SMI) and long-term survival of gastric cancer patients remains unclear up to now. The aim of this meta-analysis was to identify the prognostic value of pretreatment SMI in gastric cancer.Methods: The PubMed, EMBASE and Web of Science electronic databases were searched up to 5 June 2022 for relevant studies. The primary outcome was overall survival (OS) and the second outcomes were disease-free survival (DFS) and cancer-specific survival (CSS). The hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to assess the relationship between pretreatment SMI and survival of gastric cancer patients. All statistical analyses were conducted by STATA 15.0 software.Results: A total of 31 retrospective studies involving 12,434 patients were enrolled in this meta-analysis. The pooled results demonstrated that lower pretreatment was significantly associated with poorer OS (HR = 1.53, p < 0.001). Besides, lower pretreatment SMI was also related with worse DFS (HR = 1.39, p < 0.001) and CSS (HR = 1.96, p < 0.001).Conclusion: Pretreatment SMI was significantly associated with prognosis of gastric cancer patients and lower SMI predicted worse survival. However, more prospective high-quality studies are still needed to verify our findings.

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“…Studies have shown that a high protein diet combined with aerobic fitness can promote muscle protein synthesis, so as to reduce the incidence of postoperative complications and shorten the length of hospital stay. 7 Second, in table 1, the albumin of each group needs to be considered for inclusion in this study. One study confirmed that sarcopenia was significantly associated with old age, low BMI, and low albumin.…”

Section: Aerobic Fitness and Muscle Density Play A Vital Role In Post...mentioning

confidence: 99%

Aerobic fitness and muscle density play a vital role in postoperative complications in colorectal cancer surgery

Chen

Sun

2022

Journal of Surgical Oncology

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Effects of Sarcopenia on Postoperative Outcomes in Patients Who Underwent Gastrectomy for Gastric Cancer

Cited by 12 publications

References 40 publications

Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis

Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis

Prognostic role of pretreatment skeletal muscle index in gastric cancer patients: A meta-analysis

Aerobic fitness and muscle density play a vital role in postoperative complications in colorectal cancer surgery

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