1. Effect of sarcopenia on short-term and long-term outcomes of older patients with locally advanced gastric cancer: a multicenter study.
- Author
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Zheng, Zi-Fang, Lin, Guang-Tan, Zhong, Qing, Wu, Dong, Lu, Jun, Wang, Jia-Bin, Chen, Qi-Yue, Lin, Jian-Xian, Cao, Long-Long, Lin, Mi, Zheng, Shu-Ping, Xie, Jian-Wei, Zheng, Chao-Hui, Huang, Chang-Ming, and Li, Ping
- Subjects
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STOMACH tumors , *ADENOCARCINOMA , *PATIENT aftercare , *STATISTICS , *SURGICAL blood loss , *NUTRITIONAL assessment , *HEMOGLOBINS , *CONFIDENCE intervals , *ACADEMIC medical centers , *PREOPERATIVE period , *MULTIPLE regression analysis , *LOG-rank test , *MULTIVARIATE analysis , *CONVALESCENCE , *SARCOPENIA , *RETROSPECTIVE studies , *SURGICAL complications , *CANCER relapse , *PATIENT readmissions , *HEALTH status indicators , *TREATMENT effectiveness , *COMPARATIVE studies , *CANCER patients , *RISK assessment , *T-test (Statistics) , *SERUM albumin , *TUMOR classification , *SURVIVAL rate , *SURVIVAL analysis (Biometry) , *DESCRIPTIVE statistics , *KAPLAN-Meier estimator , *CHI-squared test , *RESEARCH funding , *ODDS ratio , *DATA analysis software , *LOGISTIC regression analysis , *OVERALL survival , *PROPORTIONAL hazards models , *NUTRITIONAL status , *COMORBIDITY , *DISEASE risk factors , *EVALUATION , *OLD age - Abstract
Objective: To assess the effect of preoperative sarcopenia on the short-term and long-term outcomes in older patients with locally advanced gastric cancer (LAGC). Methods: Clinicopathological data of older patients with LAGC who underwent radical surgery were retrospectively analyzed. Sarcopenia was defined as a skeletal muscle index of less than 36.4 cm2/m2 for men and less than 28.4 cm2/m2 for women. Comparing the postoperative complications and survival between sarcopenia and non-sarcopenia groups using multicenter data. Results: A total of 406 older patients with LAGC were included in the analysis, including 145 (35.7%) with sarcopenia and 261 (64.3%) with non-sarcopenia. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for postoperative complications with CD grade ≥ II (OR 1.616; P < 0.05). Kaplan–Meier survival curve analysis showed that the 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) in the sarcopenia group were lower than those in the non-sarcopenia group (P both < 0.05). Multivariate Cox regression analyses showed that sarcopenia was an independent prognostic factor for 5-year OS and RFS (P both < 0.05). The 5-year recurrence rate in the sarcopenia group was 57.2%, which was significantly higher than that in the non-sarcopenia group (46.4%; P = 0.036). Recurrence pattern analysis showed that the incidence of distant metastases in patients with sarcopenia (42.8%) was significantly higher than non-sarcopenia (31.4%; P = 0.022). Conclusion: Sarcopenia serves as a valuable predictor of both short-term and long-term outcomes in older patients with LAGC. Therefore, the significance of assessing preoperative nutritional status and implementing thorough postoperative follow-up for older LAGC patients with sarcopenia should be emphasized. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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