Impact of Sarcopenia on Overall Survival in Patients With Resectable Periampullary Cancer: A Retrospective Study

Sarcopenia is commonly observed in patients with periampullary cancer. Even in early-stage cases, it is associated with higher morbidity and poor postoperative outcomes. In this study, we aimed to evaluate the impact of sarcopenia on overall survival in patients with resectable periampullary cancer.

We retrospectively analyzed data from all patients with resectable periampullary cancer who met the inclusion criteria and underwent curative surgery at Songklanagarind Hospital between 2013 and 2023. All eligible patients had preoperative abdominal computed tomography scans, and we calculated the skeletal muscle index (SMI) at the L3 vertebral level. Patients were categorized into sarcopenia and non-sarcopenia groups based on SMI thresholds. We compared baseline characteristics, laboratory parameters, and overall survival using Kaplan-Meier analysis.

A total of 139 patients were included, with 71 in the sarcopenia group and 68 in the non-sarcopenia group. Patients with sarcopenia were older (66.1 ± 10 vs. 60.2 ± 11 years, p = 0.001). The 5-year survival rate was lower in the sarcopenia group (50.2%) than in the non-sarcopenia group (53.0%); however, the difference was not statistically significant (p = 0.161). Significant survival outcomes were observed in patients with postoperative improved SMI (58.8% vs. 44.5%, p = 0.019).

Preoperative sarcopenia is a key negative prognostic factor for overall survival and postoperative outcomes in patients with resectable periampullary cancer. Enhancing postoperative SMI through exercise and nutritional intervention should be integrated in postoperative care to improve survival outcomes in this population.