Abstract
Purpose
One-year mortality is vital for elderly oncologic patients undergoing surgery. Recent studies have demonstrated that sarcopenia can predict outcomes after major abdominal surgeries, but the association of sarcopenia and 1-year mortality has never been investigated in a prospective study.
Methods
We conducted a prospective study of elderly patients (≥65 years) who underwent curative gastrectomy for gastric cancer from July 2014 to July 2015. Sarcopenia was determined by the measurements of muscle mass, handgrip strength, and gait speed. Univariate and multivariate analyses were used to identify the risk factors associated with 1-year mortality.
Results
A total of 173 patients were included, in which 52 (30.1 %) patients were identified as having sarcopenia. Twenty-four (13.9 %) patients died within 1 year of surgery. Multivariate analysis showed that sarcopenia was an independent risk factor for 1-year mortality. Area under the receiver operating characteristic curve demonstrated an increased predictive power for 1-year mortality with the inclusion of sarcopenia, from 0.835 to 0.868. Solely low muscle mass was not predictive of 1-year mortality in the multivariate analysis.
Conclusions
Sarcopenia is predictive of 1-year mortality in elderly patients undergoing gastric cancer surgery. The measurement of muscle function is important for sarcopenia as a preoperative assessment tool.
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Funding
This work was funded by the Shanghai Science and Technology Committee (16411954200), the foundation of the Health Department of Zhejiang province (2016139771), and the clinical nutriology of the medical supporting discipline of Zhejiang province.
Author contributions
C.L.Z. and Z.Y. contributed to the study design. X.X.C., X.Y.C., S.L.W., X.L.C., and X.S. collected the data. D.D.H. and X.X.C. did the analysis and interpretation of data. D.D.H. wrote the article. C.L.Z. revised the article and took the decision to submit the article for publication.
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All authors reported no biomedical financial interests or potential conflicts of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Dong-Dong Huang and Xiao-Xi Chen have contributed equally to this work.
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Huang, DD., Chen, XX., Chen, XY. et al. Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study. J Cancer Res Clin Oncol 142, 2347–2356 (2016). https://doi.org/10.1007/s00432-016-2230-4
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DOI: https://doi.org/10.1007/s00432-016-2230-4