The effect of sarcopenia on postoperative adverse events after endoscopic submucosal dissection for early...

Sarcopenia is an age-related geriatric syndrome. We aimed to investigate the association between sarcopenia and adverse events after endoscopic submucosal dissection (ESD) for gastrointestinal early-stage cancer and precancerous lesions.

We enrolled 180 patients with gastrointestinal lesions who underwent ESD in the First Hospital of Hebei Medical University between April 2020 and November 2023 and divided them into the sarcopenia group (31 patients) and the non-sarcopenia group (149 patients). Their clinical information, ESD-related postoperative complications were then compared.

The median age was higher (p < 0.05) and body mass index (BMI), albumin (ALB) level, and prognostic nutritional index (PNI) were lower (all p < 0.05) in the sarcopenia group compared to the non-sarcopenia group. The percentage of those with Common Terminology Criteria for Adverse Events (CTCAE) ≥ grade 1 was higher in the sarcopenia group (p < 0.01). Univariate logistic regression analysis showed that ALB, PNI and sarcopenia are risk factors for CTCAE ≥ 1 (both p < 0.05). Multivariate analyses indicated that sarcopenia (OR = 2.961; 95% CI: 1.220-7.188; p < 0.05) was a significant independent risk factor.

Sarcopenia is an independent risk factor for adverse events after ESD for gastrointestinal early cancer and precancerous lesions. Early preoperative identification and improvement of sarcopenic status by clinicians are therefore critical for enhancing ESD safety and optimizing patient recovery trajectories.