1. Effect of sarcopenia on short- and long-term outcomes in patients with gastric neuroendocrine neoplasms after radical gastrectomy: results from a large, two-institution series
- Author
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Chang-Ming Huang, Ru-Hong Tu, Jian-Wei Xie, Zhi-Fang Zheng, Mi Lin, Zhen Xue, Chao-Hui Zheng, Bin-Bin Xu, Jian-Xian Lin, Yu Xu, Ping Li, Qingliang He, Ze-Ning Huang, Ju-Li Lin, Jia-Bin Wang, Long-Long Cao, Jun Lu, and Qi-Yue Chen
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Sarcopenia ,Multivariate analysis ,Gastric Mixed Adenoneuroendocrine Carcinoma ,030230 surgery ,Gastroenterology ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Gastrectomy ,Stomach Neoplasms ,Internal medicine ,Genetics ,Medicine ,Humans ,Overall survival ,Radical surgery ,Risk factor ,Pathological ,Aged ,Retrospective Studies ,Proportional hazards model ,business.industry ,Gastric neuroendocrine neoplasms ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Survival Analysis ,Neuroendocrine Tumors ,Treatment Outcome ,Oncology ,Risk factors ,030220 oncology & carcinogenesis ,Female ,business ,human activities ,Research Article - Abstract
Background The relationship between sarcopenia and the prognoses of patients with gastric neuroendocrine neoplasms (g-NENs) is unclear. This study was designed to explore the effects of sarcopenia on short-term and long-term outcomes of patients with g-NENs after radical gastrectomy. Methods This study retrospectively collected data from 138 patients with g-NENs after radical gastrectomy. The skeletal muscle index (SMI) diagnostic threshold for sarcopenia was determined using X-tile software. Cox regression analyses were performed to determine the independent risk factors for 3-year overall survival (OS) and 3-year recurrence-free survival (RFS). Results In this study, 59 patients (42.8%) were diagnosed with sarcopenia. Among patients in the sarcopenia group and nonsarcopenia group, the incidences of total postoperative complications were 33.9 and 30.4%, incidences of serious postoperative complications were 0 and 3.7%, incidences of postoperative surgical complications were 13.6 and 15.2%, and incidences of postoperative systemic complications were 20.3 and 15.2%, respectively (all p > 0.05). The 3-year OS and RFS rates were significantly worse in the sarcopenia group than in the nonsarcopenia group (OS: 42.37% vs 65.82%, p = 0.004; RFS: 52.54% vs 68.35%, p = 0.036). The multivariate analysis revealed a relation between sarcopenia and the long-term prognoses of patients with g-NENs. A stratified analysis based on the pathological type revealed that the Kaplan-Meier curve was only significantly different in patients with gastric mixed adenoneuroendocrine carcinoma (gMANEC) (OS: 40.00% vs 71.79%, p = 0.007; RFS: 51.43% vs 74.36%, p = 0.026); furthermore, the multivariate analysis identified sarcopenia as an independent risk factor for patients with gMANEC (p Conclusions Sarcopenia is not related to the short-term prognoses of patients with g-NENs. Sarcopenia is an independent risk factor for patients with gMANEC after radical surgery.
- Published
- 2020