Impact of Preoperative Handgrip Strength on Postoperative Outcome after Radical Gastrectomy for Gastric Cancer Patients

Abstract

In this study, we investigated whether preoperative low-handgrip strength (HGS) defined by the Asian working group for sarcopenia could be a predictor of postoperative outcomes in patients with gastric cancer. A total of 327 patients who underwent radical gastrectomy for c-stage I–III primary gastric cancer with pre-operative HGS records were included. The cut-off values of HGS were defined as 28 kg for males and 18 kg for females, with values below and above the cut-off defined as low-HGS and high-HGS, respectively. The primary outcome was infectious complications. We compared the postoperative outcomes of the groups after adjusting for the background using propensity score matching. Of the 327 patients, 246 (75.2%) and 81 (24.8%) were in the high and low-HGS groups, respectively. After adjusting for background, there were 57 patients in both groups. After matching, the low-HGS group had significantly more infectious complications (17.5% vs. 1.8%, p = 0.008). Multivariate analysis of infectious complications in the low-HGS group demonstrated chronic kidney disease and diabetes as independent risk factors (odds ratio 4.390, 95% confidence interval 1.120–17.20, p = 0.034). Preoperative low-HGS according to the Asian criteria was associated with infectious complications after gastrectomy. Chronic kidney disease and diabetes were independent risk factors for infectious complications among patients with low-HGS.

Quality of Life, Sarcopenia and Nutritional Status in Patients with Esophagogastric Tumors before and after Neoadjuvant Therapy

“…Another aspect recently gaining importance as a clinical prognostic factor in upper GI cancers is sarcopenia, which has not only been shown to be prognostic for progress-free and overall survival [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], but also reportedly correlates with postoperative complications like pneumonia, and might even influence anastomotic leakage [ 31 , 35 , 39 , 40 , 41 , 42 ]. Specifically, loss of skeletal muscle during neoadjuvant treatment has been suggested to raise anastomotic leakage rates, while chemotherapy, according to the FLOT protocol, has been shown to raise sarcopenia rates from 16% to 33% [ 40 , 43 ].…”