The Impact of Sarcopenia in the Prognosis of Patients with Gastric Cancer Undergoing Surgery

Résumé

Introduction: Surgical treatment is the first-line treatment for patients with resectable gastric cancer. The impact of preoperative sarcopenia on the post-operative outcomes of these patients remains unclear. In this context, we evaluate the association between the presence of sarcopenia and the prognosis of patients with gastric cancer undergoing surgery.

Methods: It was conducted a retrospective, observational, longitudinal, descriptive and analytic study. Sarcopenia was diagnosed by measuring the total abdominal area with the ImageJ® software, using axial images of preoperative computed tomography scans. 147 patients who underwent gastrectomy at the Hospital de Braga between January/2008 and December/2016 were included in the study. The Prado cut-off was used to define sarcopenia. Statistical analysis was performed using SPSS®-26.0 version. The Overall Survival (OS) of these patients was assessed using the Kaplan-Meier method. Multivariate Cox Regression was used to find risk factors for OS.

Results: Thirty two (21.8%) of the patients had sarcopenia. Sarcopenia was significantly more present in males (p=0.040), not having, however, relation with patients' age (p=0.114). Sarcopenia has been shown to influence the presence (p=0.01) of postoperative complications, length of hospital stay (p<0.001) and OS (p=0.027). However, it cannot be considered an independent prognostic factor for worse OS. Only age and TNM stage proved to be independent risk factors for the OS.

Conclusion: In this study, sarcopenia showed to influence the incidence and severity of postoperative complications, the length of hospital stay and the OS of patients with Gastric Cancer who underwent surgery.