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Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach
Introduction Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations. Methods Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma...
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| Published in: | Journal of surgical oncology 2019-09, Vol.120 (3), p.473-482 |
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| cites | cdi_FETCH-LOGICAL-c3539-95747b9b678acf2f7ef915e17de88e7dc577089298426ed1ed9f8300988643dc3 |
| container_end_page | 482 |
| container_issue | 3 |
| container_start_page | 473 |
| container_title | Journal of surgical oncology |
| container_volume | 120 |
| creator | Sierzega, Marek Chrzan, Robert Wiktorowicz, Milosz Kolodziejczyk, Piotr Richter, Piotr |
| description | Introduction
Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations.
Methods
Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma between 2012 and 2015 were reviewed to evaluate the impact of sarcopenia. The definition of sarcopenia was based on the lumbar skeletal muscle index (SMI) using cut‐off values formulated by the international consensus definitions of sarcopenia (SMI |
| doi_str_mv | 10.1002/jso.25509 |
| format | article |
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Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations.
Methods
Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma between 2012 and 2015 were reviewed to evaluate the impact of sarcopenia. The definition of sarcopenia was based on the lumbar skeletal muscle index (SMI) using cut‐off values formulated by the international consensus definitions of sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women).
Results
Sixty (43%) of 138 patients were sarcopenic. Sarcopenia was associated with postoperative morbidity (43% vs 23%; P = .011), major postoperative complications (Clavien‐Dindo ≥3a; 36% vs 21%; P = .035), and reoperations (23% vs 9%; P = .020). Patients with sarcopenia also had prolonged postoperative hospital stay (8.0 vs 6.5 days; P = .010). The overall median survival of patients with sarcopenia was significantly lower than those with normal skeletal muscles (11.0 vs 36.7 months; P = .005) and sarcopenia remained an independent prognostic factor with an odds ratio of 1.94 (95% confidence interval, 1.08 to 3.48; P = .026).
Conclusion
Sarcopenia, defined by SMI, is associated with an increased risk of postoperative morbidity and impaired long‐term survival.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25509</identifier><identifier>PMID: 31124178</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - mortality ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Cancer surgery ; complications ; Female ; Gastric cancer ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Prognosis ; Proportional Hazards Models ; Sarcopenia ; Sarcopenia - diagnostic imaging ; Sarcopenia - mortality ; Sarcopenia - physiopathology ; skeletal muscle index ; Stomach Neoplasms - diagnostic imaging ; Stomach Neoplasms - mortality ; Stomach Neoplasms - surgery ; Tomography, X-Ray Computed</subject><ispartof>Journal of surgical oncology, 2019-09, Vol.120 (3), p.473-482</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-95747b9b678acf2f7ef915e17de88e7dc577089298426ed1ed9f8300988643dc3</citedby><cites>FETCH-LOGICAL-c3539-95747b9b678acf2f7ef915e17de88e7dc577089298426ed1ed9f8300988643dc3</cites><orcidid>0000-0002-7008-9026</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31124178$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sierzega, Marek</creatorcontrib><creatorcontrib>Chrzan, Robert</creatorcontrib><creatorcontrib>Wiktorowicz, Milosz</creatorcontrib><creatorcontrib>Kolodziejczyk, Piotr</creatorcontrib><creatorcontrib>Richter, Piotr</creatorcontrib><title>Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Introduction
Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations.
Methods
Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma between 2012 and 2015 were reviewed to evaluate the impact of sarcopenia. The definition of sarcopenia was based on the lumbar skeletal muscle index (SMI) using cut‐off values formulated by the international consensus definitions of sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women).
Results
Sixty (43%) of 138 patients were sarcopenic. Sarcopenia was associated with postoperative morbidity (43% vs 23%; P = .011), major postoperative complications (Clavien‐Dindo ≥3a; 36% vs 21%; P = .035), and reoperations (23% vs 9%; P = .020). Patients with sarcopenia also had prolonged postoperative hospital stay (8.0 vs 6.5 days; P = .010). The overall median survival of patients with sarcopenia was significantly lower than those with normal skeletal muscles (11.0 vs 36.7 months; P = .005) and sarcopenia remained an independent prognostic factor with an odds ratio of 1.94 (95% confidence interval, 1.08 to 3.48; P = .026).
Conclusion
Sarcopenia, defined by SMI, is associated with an increased risk of postoperative morbidity and impaired long‐term survival.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer surgery</subject><subject>complications</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Sarcopenia</subject><subject>Sarcopenia - diagnostic imaging</subject><subject>Sarcopenia - mortality</subject><subject>Sarcopenia - physiopathology</subject><subject>skeletal muscle index</subject><subject>Stomach Neoplasms - diagnostic imaging</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - surgery</subject><subject>Tomography, X-Ray Computed</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kU1rGzEQhkVoaRy3h_yBIOglOWwsaT8kHYtJvzCk0JYeF1madWR2pa2kbfC5f7xy1umh0NMwzDMPM7wIXVJySwlhq330t6yuiTxDC0pkU0gixQu0yDNWVFySc3QR454QImVTvULnJaWsolws0O8vwe-cj8lqrJzBYwBjdbK_ANth7K1WyXoXse9wVEH7EZxV2Dr8A2KC4PCYAXAp4skZCDtv3Q7vVEwhCwNE0PN-5wPWWWCdH9TRlh4Ax5Qb_fAavexUH-HNqS7R9_d339Yfi839h0_rd5tCl3UpC1nzim_ltuFC6Y51HDpJa6DcgBDAja45J0IyKSrWgKFgZCfK_LMQTVUaXS7R9ewdg_855fvbwUYNfa8c-Cm2jJWMUinKKqNv_0H3fgouX5ephlekoUxk6mamdPAxBujaMdhBhUNLSXtMps3JtE_JZPbqZJy2A5i_5HMUGVjNwKPt4fB_U_v56_2s_APxd5m8</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Sierzega, Marek</creator><creator>Chrzan, Robert</creator><creator>Wiktorowicz, Milosz</creator><creator>Kolodziejczyk, Piotr</creator><creator>Richter, Piotr</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7008-9026</orcidid></search><sort><creationdate>20190901</creationdate><title>Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach</title><author>Sierzega, Marek ; Chrzan, Robert ; Wiktorowicz, Milosz ; Kolodziejczyk, Piotr ; Richter, Piotr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-95747b9b678acf2f7ef915e17de88e7dc577089298426ed1ed9f8300988643dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer surgery</topic><topic>complications</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Sarcopenia</topic><topic>Sarcopenia - diagnostic imaging</topic><topic>Sarcopenia - mortality</topic><topic>Sarcopenia - physiopathology</topic><topic>skeletal muscle index</topic><topic>Stomach Neoplasms - diagnostic imaging</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - surgery</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sierzega, Marek</creatorcontrib><creatorcontrib>Chrzan, Robert</creatorcontrib><creatorcontrib>Wiktorowicz, Milosz</creatorcontrib><creatorcontrib>Kolodziejczyk, Piotr</creatorcontrib><creatorcontrib>Richter, Piotr</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sierzega, Marek</au><au>Chrzan, Robert</au><au>Wiktorowicz, Milosz</au><au>Kolodziejczyk, Piotr</au><au>Richter, Piotr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>120</volume><issue>3</issue><spage>473</spage><epage>482</epage><pages>473-482</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Introduction
Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations.
Methods
Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma between 2012 and 2015 were reviewed to evaluate the impact of sarcopenia. The definition of sarcopenia was based on the lumbar skeletal muscle index (SMI) using cut‐off values formulated by the international consensus definitions of sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women).
Results
Sixty (43%) of 138 patients were sarcopenic. Sarcopenia was associated with postoperative morbidity (43% vs 23%; P = .011), major postoperative complications (Clavien‐Dindo ≥3a; 36% vs 21%; P = .035), and reoperations (23% vs 9%; P = .020). Patients with sarcopenia also had prolonged postoperative hospital stay (8.0 vs 6.5 days; P = .010). The overall median survival of patients with sarcopenia was significantly lower than those with normal skeletal muscles (11.0 vs 36.7 months; P = .005) and sarcopenia remained an independent prognostic factor with an odds ratio of 1.94 (95% confidence interval, 1.08 to 3.48; P = .026).
Conclusion
Sarcopenia, defined by SMI, is associated with an increased risk of postoperative morbidity and impaired long‐term survival.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31124178</pmid><doi>10.1002/jso.25509</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7008-9026</orcidid></addata></record> |
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| subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - mortality Adenocarcinoma - surgery Adult Aged Aged, 80 and over Cancer surgery complications Female Gastric cancer Humans Kaplan-Meier Estimate Male Middle Aged Neoplasm Staging Postoperative Complications - etiology Postoperative Complications - mortality Prognosis Proportional Hazards Models Sarcopenia Sarcopenia - diagnostic imaging Sarcopenia - mortality Sarcopenia - physiopathology skeletal muscle index Stomach Neoplasms - diagnostic imaging Stomach Neoplasms - mortality Stomach Neoplasms - surgery Tomography, X-Ray Computed |
| title | Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach |
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