Measurement of muscle quantity/quality has additional predictive value for postoperative complications and long-term survival after gastrectomy for gastric cancer in patients with probable sarcopenia as defined by the new EWGSOP2 consensus: Analysis from a large-scale prospective study

Huang, Dongdong; Cai, Hui-Yang; Wang, Wenbin; Song, Hao-Nan; Luo, Xin; Dong, Wen-Xi; Dong, Qian-Tong; Chen, Xiaolei; Yan, Jingyi

doi:10.1016/j.nut.2021.111156

Cited by 15 publications

(12 citation statements)

References 33 publications

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“…A study involving 234 patients after liver resection for malignant tumours reported that patients with sarcopenia had a statistically significantly higher rate of 90‐day morbidity than patients in the other groups and had longer hospital stays and higher readmission rates 25 . Another study involving 404 patients undergoing radical gastrectomy for gastric cancer also found that sarcopenia significantly increased post‐operative morbidity in gastric cancer patients, resulting in longer post‐operative hospital stay and shorter overall survival and disease‐free survival 26 . The reasons for the high morbidity in elderly patients with sarcopenia may be as follows: (1) The decrease of amino acids released by skeletal muscle of sarcopenia patients lead to the lack of raw materials for the synthesis of acute phase proteins by the liver.…”

Section: Discussionmentioning

confidence: 99%

Effects of sarcopenia and frailty on postoperative recovery in elderly patients: A prospective cohort study

Guo,

Wang,

et al. 2023

J cachexia sarcopenia muscle

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BackgroundSarcopenia and frailty are both age‐related declines in functional reserve that are linked to adverse health outcomes. It is critical to know about the outcomes of a combination of these conditions. The study aimed to investigate the effects of sarcopenia and frailty on postoperative recovery in elderly patients and to explore risk factors.MethodsThis prospective cohort study was conducted among 608 patients aged ≥60 years, American Society of Anesthesiologists I‐III, who were scheduled to undergo thoracic (non‐cardiac) and abdominal surgery from 1 March 2022 to 31 October 2022 at the Affiliated Hospital of Xuzhou Medical University. Frailty was measured by the 28‐item frailty index, and sarcopenia was assessed sarcopenia was assessed by skeletal muscle index in computed tomographic scan, handgrip strength and 6‐m walk. Participants were classified as follows: Group A: both sarcopenia and frailty; Group B: sarcopenia only; Group C: frailty only; and Group D: neither frailty nor sarcopenia. The primary outcome was 90‐day morbidity. Multivariable logistic regression model was used to estimate the association between sarcopenia, frailty and 90‐day morbidity.ResultsThe median (interquartile range) age of participants was 68 (64–72) years, and 62.7% were men. The prevalence rates of sarcopenia and frailty were 32.8% and 47.6%, respectively. The 90‐day morbidity in Group A was 58.5%, in Group B was 46.2%, in Group C was 42.0% and in Group D was 28.8%, and the difference was significant (P < 0.001). In the multivariable analysis, both sarcopenia and frailty [odds ratio (OR), 2.21; 95% confidence interval (CI), 1.26–3.89], sarcopenia only (OR, 1.84; 95% CI, 1.01–3.36), frailty only (OR, 1.77; 95% CI, 1.03–3.03), women (OR, 0.67; 95% CI, 0.45–0.99), body mass index (OR, 0.94; 95% CI, 0.88–0.99), pre‐operative albumin (OR, 0.96; 95% CI, 0.91–1.00) and operative stress score (OSS) [OSS 3 (OR, 2.09; 95% CI, 1.21–3.67); OSS 4–5 (OR, 3.81; 95% CI, 2.31–6.42)] were independently associated with 90‐day morbidity. In the multivariable analysis with inverse probability weighting adjusted cohort, sarcopenia and frailty were also significantly associated with 90‐day morbidity.ConclusionsSarcopenia and frailty were associated with higher risks of postoperative 90‐day morbidity in elderly patients alone and in combination. Sex, body mass index, pre‐operative albumin and operative stress were also independent factors for postoperative morbidity within 90 days.

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Section: Discussionmentioning

confidence: 99%

Effects of sarcopenia and frailty on postoperative recovery in elderly patients: A prospective cohort study

Guo,

Wang,

et al. 2023

J cachexia sarcopenia muscle

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“…In our study, the overall prevalence of sarcopenia was 24.5%. Some researchers have investigated the prevalence of sarcopenia in older adults or in patients with cancer (mostly in patients undergoing surgical procedures [ 33 , 34 , 35 ]), but few have focused on older patients with cancer. In a study that included 108 patients with cancer aged ≥60 (mean ± standard deviation age: 70.6 ± 7.4; females: 52.3%, main cancer types: colorectal (27.8%) and gastric (22.2%); advanced cancer: 54.6%), the prevalence of sarcopenia was 24.1% according to the EWGSOP2 definition and 25.9% when using the calf circumference as a proxy for muscle mass [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Four Sarcopenia Criteria in Older Patients with Cancer, and Their Predictive Value for 6-Month Mortality: The NutriAgeCancer National Prospective Cohort Study

et al. 2023

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Older cancer patients have an elevated risk of sarcopenia. The aim was to estimate the prevalence of four criteria for sarcopenia case finding, assessment, diagnosis, and severity determination: abnormal strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F), low hand-grip strength (HGS), low arm circumference (AC, a muscle mass proxy), and low physical performance (PP). Sarcopenia (low HGS and AC) and severe sarcopenia (low HGS, AC, and PP) and their predictive values for 6-month mortality were estimated in the whole population and by metastatic status. We analyzed data from the NutriAgeCancer French nationwide study of cancer patients aged ≥70 referred for geriatric assessment before anti-cancer treatment. We performed Cox proportional hazards analysis for each criterion separately and all criteria combined. Overall, 781 patients from 41 geriatric oncology clinics were included (mean age: 83.1; females: 53%; main cancer types: digestive (29%) and breast (17%); metastases: 42%). The prevalence of abnormal SARC-F, low HGS, a low AC, low PP, sarcopenia, and severe sarcopenia were, respectively, 35.5%, 44.6%, 44.7%, 35.2%, 24.5%, and 11.7%. An abnormal SARC-F and/or low HGS, sarcopenia, and severe sarcopenia were associated with 6-month mortality in patients with metastases (adjusted hazard ratios [95% confidence interval]: 2.72 [1.34–5.49], 3.16 [1.48–6.75] and 6.41 [2.5–16.5], respectively). Sarcopenia was strongly predictive of 6-month mortality in patients with metastatic cancer.

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“…Our results are consistent with recent findings supporting not only the independent negative impact of low muscle strength in different cancer types, but also its additional predictive value of worse outcomes (e.g. perioperative outcome and survival) when combined with reduced lean body mass as estimated by BIA or assessed by CT. 13 , 14 , 15 , 16 , 17 , 39 Burtin et al found that muscle weakness alone predicted survival in patients with lung cancer and that it significantly worsened prognosis when associated with reduced fat‐free mass, particularly in patients with a good performance status. 14 Sarcopenia defined by reduced muscle mass (by CT) and strength was also found to predict higher rates of 90‐day morbidity than isolated weakness or low muscle mass after liver resection for malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 11 , 12 Interestingly, recent studies have addressed and highlighted that also reduced muscle function could have a negative and independent prognostic impact, resulting in increased mortality, dose‐limiting toxicity and other perioperative outcomes (e.g. length of stay, readmission rate), 13 , 14 , 15 , 16 , 17 particularly when reduced strength and lean/muscle mass coexist. 13 , 14 , 15 Its use as alternative phenotypic criterion of malnutrition for indicating reduced muscle mass––rather than other body composition parameters, such as arm muscle circumference, fat‐free mass index and muscle mass by computed tomography (CT)––has been also tested, showing a stronger prediction of mortality in patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

“…length of stay, readmission rate), 13 , 14 , 15 , 16 , 17 particularly when reduced strength and lean/muscle mass coexist. 13 , 14 , 15 Its use as alternative phenotypic criterion of malnutrition for indicating reduced muscle mass––rather than other body composition parameters, such as arm muscle circumference, fat‐free mass index and muscle mass by computed tomography (CT)––has been also tested, showing a stronger prediction of mortality in patients with cancer. 18 , 19 , 20 As muscle strength testing could be an informative, low‐cost, well accepted and routinely feasible procedure, 21 further study in this area are warranted.…”

Section: Introductionmentioning

confidence: 99%

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Muscle weakness as an additional criterion for grading sarcopenia‐related prognosis in patients with cancer

et al. 2021

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Measurement of muscle quantity/quality has additional predictive value for postoperative complications and long-term survival after gastrectomy for gastric cancer in patients with probable sarcopenia as defined by the new EWGSOP2 consensus: Analysis from a large-scale prospective study

Cited by 15 publications

References 33 publications

Effects of sarcopenia and frailty on postoperative recovery in elderly patients: A prospective cohort study

Effects of sarcopenia and frailty on postoperative recovery in elderly patients: A prospective cohort study

Prevalence of Four Sarcopenia Criteria in Older Patients with Cancer, and Their Predictive Value for 6-Month Mortality: The NutriAgeCancer National Prospective Cohort Study

Muscle weakness as an additional criterion for grading sarcopenia‐related prognosis in patients with cancer

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