Optimal Cutoff Values of Skeletal Muscle Index to Define Sarcopenia for Prediction of Survival in Patients with Advanced Gastric Cancer

Abstract

The cutoff values reported by Martin et al. were optimal to predict survival in patients with advanced gastric cancer.

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

“…The association between low muscle mass and postoperative complications was reported in 12 studies [12,13,[23][24][25][26][27][28][29][30][31][32] of which 9 studies reported data on severe postoperative complications (Clavien-Dindo grade ≥III) [12,[23][24][25][26][27][28]31,32]. Overall mortality was reported as an outcome measure in 9 studies [24][25][26]28,31,[33][34][35], and 5 studies reported on disease-specific mortality [28,31,[33][34][35].…”

“…Most studies were retrospective cohort studies (67%) [12,13,[24][25][26][27][28]31,33,34], although 5 were prospective in nature (33%) [23,29,30,32,35]. The majority of the studies included more men than women, with a percentage of male patients varying from 35% to 84%.…”

“…In all studies, CT-based assessment of muscle mass was performed in patients prior to surgery [12,13,[23][24][25][26][27][28][29][30][31][32][33][34][35]. Thirteen studies (87%) calculated the total two-dimensional skeletal muscle area at the level of the third lumbar vertebra [12,[23][24][25][27][28][29][30][31][32][33][34][35]. The areas of interest were determined either automatically, or by one or multiple observers.…”

“…The areas of interest were determined either automatically, or by one or multiple observers. Several normalization techniques of the skeletal muscle area were applied, of which the normalization to the squared height of the patient was the most common (93%) [12,13,23,24,[26][27][28][29][30][31][32][33][34][35]. In two studies, only the muscle area of the psoas muscle on the third lumbar level was measured, which was normalized to the squared height [13,26].…”

“…Only one study normalized the skeletal muscle area to the total body surface area [25]. Subsequently, patients were frequently categorized in low muscle mass versus normal muscle mass, as based on literature-based [12,13,23,24,27,29,30,32,33] or data-dependent cutoff values [25,26,28,31,34,35]. All cutoff values were sex-specific, and two studies used different muscle mass cutoff values for obese and nonobese patients (body mass index <25 kg/m 2 and ≥25 kg/m 2 ) [12,24].…”