Global Leadership Initiative in Sarcopenia (GLIS)–defined sarcopenia increases the mortality of esophageal cancer patients after esophagectomy: A Chinese real-world cohort study

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2025-01, Vol.129, p.112600, Article 112600
• Main Authors: Huo, Zhenyu, Luo, Siyu, Chong, Feifei, Tong, Ning, Lu, Zongliang, Zhang, Mengyuan, Liu, Jie, Fang, Chunshu, Guo, Wei, Li, Na, Xu, Hongxia
• Format: Article
• Language: English
• Subjects: Aged; Alcohol; Body mass index; Cancer; Cancer therapies; China - epidemiology; Cohort analysis; Cohort Studies; East Asian People; Esophageal cancer; Esophageal Neoplasms - mortality; Esophageal Neoplasms - surgery; Esophagectomy - adverse effects; Esophagectomy - mortality; Female; GLIS; Global Leadership Initiative in Sarcopenia; Glucose; Health risks; Hospitals; Humans; Kaplan-Meier Estimate; Leadership; Male; Males; Medical diagnosis; Medical prognosis; Medical records; Metastases; Middle Aged; Mortality; Mortality risk; Muscle strength; Patients; Postoperative Complications - epidemiology; Postoperative Complications - mortality; Proportional Hazards Models; Risk Factors; Sarcopenia; Sarcopenia - mortality; Smoking; Stability; Survival analysis; Variables
• ISSN: 0899-9007; 1873-1244; 1873-1244
• DOI: 10.1016/j.nut.2024.112600

•Global Leadership Initiative in Sarcopenia (GLIS)–defined sarcopenia is highly prevalent among esophageal cancer patients.•GLIS-defined sarcopenia increases the mortality of esophageal cancer patients after esophagectomy.•This finding offers compelling evidence for the development of an operational definition of GLIS sarcopenia. To assess the impact of the definition of the Global Leadership Initiative in Sarcopenia (GLIS) on mortality in esophageal cancer (EC) patients, postesophagectomy, within a Chinese cohort and to validate the effectiveness of a new GLIS framework in oncology. We performed an observational real-world cohort study in a single center at Daping Hospital of the Army Medical University in China, spanning from December 2014 to July 2022. We used the combined definition of muscle mass and muscle strength in a new GLIS framework for the diagnosis of sarcopenia. Potential covariates were identified through univariate and multivariate analyses. The association between GLIS-defined sarcopenia and mortality was estimated using Kaplan–Meier curves and Cox models. We also conducted stratified analyses to assess the stability of multivariable Cox models. A total of 520 EC patients were included in the study, with a median follow-up of 48.7 months. A total of 229 EC patients (44.0%) were identified with GLIS-defined sarcopenia. Patients with GLIS-defined sarcopenia had significantly worse overall survival in Kaplan–Meier curves (log-rank P = 0.015). Age; sex; tumor, node, metastasis stage; blood glucose; bleeding volume in operation; and operating time were introduced as covariates in a fully adjusted Cox model. Multivariable-adjusted Cox models revealed that GLIS-defined sarcopenia was an independent prognostic factor for EC patients postesophagectomy (hazard ratio, 1.87, 95% confidence interval, 1.28–2.74, P = 0.001). Stratified analyses confirmed the stability of the relationship between GLIS-defined sarcopenia and mortality in EC patients. GLIS-defined sarcopenia is prevalent among Chinese EC patients and is linked to increased mortality risk postesophagectomy. This finding offers compelling evidence and serves as a valuable reference for the establishment of an operational definition of GLIS sarcopenia.