Laparoscopic Colorectal Resection in Patients with Sarcopenia: A Retrospective Case-Control Study

Zhang

Lü

et al. 2020

Preprint

Background: The relationship between sarcopenia and prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods: This study retrospectively collected data of 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression were used to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results: In this study, there were 59 patients (42.8%) with sarcopenia. Among the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, of serious postoperative complications 0% and 3.7%, of postoperative surgical complications 13.6% and 15.2%, of postoperative systemic complications 20.3% and 15.2% (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS:42.37% vs 65.82%, p=0.004; RFS:52.54% vs 68.35%, p=0.036). Multivariate analysis showed that sarcopenia was related to long-term prognoses of g-NENs patients. A stratified analysis based on pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, multivariate analysis showed that sarcopenia was an independent risk factor for gMANEC patients (p<0.05).Conclusion: Sarcopenia is not related to short-term prognoses of g-NENs patients. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

Section: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series

Zhang

Lü

et al. 2020

Preprint

“…As shown in the study by Tegels [34], the incidence of sarcopenia is higher in patients with gastric cancer, but it is not associated with a poor postoperative prognosis. According to Ouchi [36], sarcopenia does not increase the incidence of total and severe postoperative complications in patients with colorectal cancer [36]. In the present study, significant differences in the incidences of total postoperative complications, surgical complications and systemic complications were not observed between the patients with g-NENs presenting with and without sarcopenia.…”

Section: Discussionsupporting

confidence: 41%

“…An American study identified an association between sarcopenia and the short-term outcomes in patients with pancreatic cancer after pancreatectomy [35]. However, some studies have reported the opposite results [34,36]. As shown in the study by Tegels [34], the incidence of sarcopenia is higher in patients with gastric cancer, but it is not associated with a poor postoperative prognosis.…”

Section: Discussionmentioning

confidence: 99%

Effect of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: results from a large, two-institution series

Zhang

et al. 2020

BMC Cancer

Background The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9 and 30.4%, incidences of serious postoperative complications were 0 and 3.7%, incidences of postoperative surgical complications were 13.6 and 15.2%, and incidences of postoperative systemic complications were 20.3 and 15.2%, respectively (all p > 0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p = 0.004; RFS: 52.54% vs 68.35%, p = 0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p = 0.007; RFS: 51.43% vs 74.36%, p = 0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p < 0.05). Conclusions Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.

“…GMANEC is de ned as a malignant tumor with morphological components of glandular epithelial cells and neuroendocrine cells, both of which account for at least more than 30% [4]. Previous studies have shown that the clinical characteristics of gMANEC largely depend on the proportion of neuroendocrine carcinoma components [36,37]. Fernandes et al believe that the prognosis of gMANEC might be related to whether certain tumor components are more invasive [38].…”

Section: Discussionmentioning

confidence: 99%

Effects of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: Results from a large, two-institution series.

Xue

Lü

et al. 2020

Preprint

Background: The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy.Methods: This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS).Results: In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9% and 30.4%, incidences of serious postoperative complications were 0% and 3.7%, incidences of postoperative surgical complications were 13.6% and 15.2%, and incidences of postoperative systemic complications were 20.3% and 15.2%, respectively (all p>0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p=0.004; RFS: 52.54% vs 68.35%, p=0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p=0.007; RFS: 51.43% vs 74.36%, p=0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p<0.05).Conclusions: Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.