Muscle Quantity Meets Muscle Quality: Integrating Skeletal Muscle Index and Hand Grip Strength to Predict Surgical...

Area of Science:

• Oncology
• Surgical Outcomes
• Geriatric Medicine

Background:

• Sarcopenia, characterized by low muscle mass (Skeletal Muscle Index - SMI) and function (Hand Grip Strength - HGS), impacts surgical outcomes in upper gastrointestinal cancers.
• The combined predictive value of preoperative SMI and HGS for postoperative risk in esophago-gastric cancer surgery is not well-established.

Purpose of the Study:

• To evaluate the individual and combined predictive capabilities of preoperative SMI and HGS for major postoperative complications following curative surgery for esophageal and gastric cancers.

Main Methods:

• A prospective observational study enrolled 150 adults undergoing esophagectomy or gastrectomy for esophageal/gastric cancer.
• SMI was assessed via CT scans, and HGS was measured using a hand dynamometer.
• Major complications (Clavien-Dindo grade ≥III) were the primary outcome, analyzed using logistic regression and ROC curves.

Main Results:

• Major complications occurred in 22% of patients.
• Both low SMI and low HGS were independently associated with significantly higher complication rates (p<0.0001).
• Combined low SMI and HGS demonstrated superior predictive accuracy (AUC 0.88) compared to individual measures, predicting 60.6% of major complications.

Conclusions:

• The combined assessment of SMI and HGS significantly enhances the prediction of postoperative morbidity after esophago-gastric cancer surgery.
• Integrating SMI and HGS into preoperative evaluations can improve risk stratification for patients undergoing these procedures.