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The impact of preoperative skeletal muscle mass index-defined sarcopenia on postoperative complications and survival

Chengcong Liu¹, Yueping Li¹, Yongjing Xu¹

¹Department of Gastrointestinal Surgery, Qingdao Central Hospital, University of Health and Rehabilitation Sciences(Qingdao Central Hospital), Qingdao, 266000, China.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

|January 10, 2025

Summary

This summary is machine-generated.

Preoperative sarcopenia significantly increases the risk of complications and mortality in gastric cancer patients. Routine screening using Skeletal Muscle Mass Index (SMI) is recommended for better risk assessment.

Keywords:

Complications Disease-free survival Gastric cancer Overall survival Sarcopenia

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Area of Science:

Oncology
Surgical Outcomes
Geriatrics

Background:

Preoperative sarcopenia's impact on gastric cancer surgery outcomes is debated.
Skeletal Muscle Mass Index (SMI) is a key metric for assessing sarcopenia.
Gastric cancer patients face significant postoperative challenges.

Purpose of the Study:

To conduct a meta-analysis on preoperative sarcopenia and postoperative outcomes in gastric cancer.
To evaluate the relationship between SMI-assessed sarcopenia and complications/survival.
To provide insights into optimizing surgical care for gastric cancer patients.

Main Methods:

Systematic literature search across Embase, PubMed, and Web of Science up to July 2024.
Meta-analysis comparing outcomes between sarcopenic and non-sarcopenic gastric cancer patients.
Analysis included readmission, mortality, complication rates (overall, severe, specific), overall survival (OS), and disease-free survival (DFS).

Main Results:

42 studies and 11,981 patients were included.
Sarcopenia was linked to higher rates of complications, mortality, and readmissions (P < 0.001).
Increased risks of pulmonary, bowel obstruction, and pancreatic fistula complications were noted. Lower OS (P < 0.001) and DFS (P = 0.003) were observed in sarcopenic patients.

Conclusions:

Preoperative sarcopenia is a significant predictor of adverse postoperative outcomes and reduced survival in gastric cancer.
Routine preoperative sarcopenia screening using SMI is recommended.
SMI screening can aid in personalized risk assessment and treatment planning for gastric cancer surgery.