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Is Sarcopenic Obesity an Indicator of Poor Prognosis in Gastric Cancer Surgery? A Cohort Study in a Western Population

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Journal of Gastrointestinal Surgery

Abstract

Background

The prognostic value of sarcopenic obesity in gastric cancer surgery remains debated. We aimed to evaluate the impact on outcomes of body composition and sarcopenic obesity after gastrectomy for gastric cancer.

Methods

A retrospective review of prospectively maintained database of patients undergoing gastrectomy for gastric cancer from 2010 to 2017 was performed. Skeletal muscle mass and visceral adipose tissue were evaluated by preoperative computed tomography to define sarcopenia and obesity. Patients were classified in body composition groups according to the presence or absence of sarcopenia and obesity. Prognostic factors for survival were assessed by multivariate Cox analysis.

Results

Of the 198 patients undergoing gastrectomy for gastric cancer, 90 (45.4%) patients were sarcopenic, 130 (67.7%) obese, and in the subclassification for body composition categories: 33 (17%) nonsarcopenic nonobesity, 75 (38%) non sarcopenic obesity, 35 (17%) sarcopenic nonobesity, and 55 (28%) sarcopenic obesity. No category of body composition was a predictor of postoperative complications and worse overall and disease-free survival outcomes. Multivariable analysis identified ASA III classification, preoperative weight loss > 10%, postoperative surgical re-intervention, and advanced tumor stage as independent prognostic factors for overall survival, and patients aged 75 years or older, preoperative weight loss > 10%, elevated netrophil-lymphocyte ratio, and advanced tumor stage as independent prognostic factors for disease-free survival.

Conclusions

Sarcopenia, obesity, and sarcopenic obesity were not associated with worse outcomes after gastric cancer surgery.

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Authors and Affiliations

  1. General and Digestive Surgery Department, Vall d´Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), 119-129, 08035, Barcelona, Spain

    V. Rodrigues, F. Landi, S. Castro, N. Rodríguez, A. Gantxegi, J. Pradell, M. López-Cano & M. Armengol

  2. Department of HPB and Transplant Surgery, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain

    F. Landi

  3. Institut de Diagnostic per la Imatge, Vall d´Hebron University Hospital, Barcelona, Spain

    R. Mast

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  1. V. Rodrigues
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Contributions

V. Rodrigues made substantial contributions to the conception or design of the work, the acquisition, analysis and interpretation of data for the work.

F. Landi made substantial contributions to the acquisition of data and made drafting the work and revising it critically for important intellectual content.

R. Mast made substancial contributions to the acquisition of data for the work.

S. Castro and N. Rodríguez made agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

J. Pradell, A. Gantxegi, and M. López-Cano made drafting the work and revising it critically for important intellectual content.

M. Armengol made the final approval of the version to be published.

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Correspondence to V. Rodrigues.

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Rodrigues, V., Landi, F., Castro, S. et al. Is Sarcopenic Obesity an Indicator of Poor Prognosis in Gastric Cancer Surgery? A Cohort Study in a Western Population. J Gastrointest Surg 25, 1388–1403 (2021). https://doi.org/10.1007/s11605-020-04716-1

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