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Role of Sarcopenia in Predicting the Postoperative Morbidity and Perioperative Mortality in Patients Undergoing Elective Surgery for Gastric Cancer

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Abstract

Purpose of Study

This study was done to assess the effect of sarcopenia and other risk factors on the postoperative morbidity and perioperative mortality of patients undergoing elective surgery for gastric cancer.

Methods

This was a prospective cohort study comprising a single group of patients undergoing elective surgery for gastric cancer carried out in a tertiary care center in India. Patients diagnosed with gastric cancer underwent contrast-enhanced computed tomography preoperatively. Patients were considered sarcopenic when their skeletal muscle index (SMI) was < 34.9 cm2/m2 for women and < 40.8 cm2/m2 for men. Patients were planned for surgery ranging from gastrectomy with curative intent to palliative gastrojejunostomy. Postoperative complications including mortality were noted for 30 days following surgery and graded according to the Clavien–Dindo classification. The role of sarcopenia and other risk factors on the postoperative outcome of patients was noted.

Results

A total of 100 patients were included in the study. There was a high prevalence of sarcopenia (62%) among patients with gastric cancer who underwent elective surgery. However, sarcopenia was not associated with any postoperative complication (p > 0.05) including 30-day mortality (p = 0.155), prolonged postoperative hospital stay (p = 0.876), or 30-day readmission rate (0.524). Among the variables considered, only esophagojejunostomy (p < 0.001) was associated with a poor postoperative outcome.

Conclusion

The present study showed that there was a high prevalence of sarcopenia (62%) in patients undergoing elective surgery for gastric cancer. However, it did not adversely affect the postoperative outcome. Among the variables considered, esophagojejunostomy alone was associated with a poor postoperative outcome.

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Data Availability

Data and material will be provided for the editorial board if necessary.

Code Availability

Not applicable.

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Acknowledgements

The authors would like to thank Dr. Karthika G, Junior resident, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India, for her assistance in doing the statistical analysis.

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Authors and Affiliations

  1. Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India

    Ramanan Sinduja, Amaranathan Anandhi, Sathasivam Sureshkumar & Vikram Kate

  2. Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Deepak Barathi

  3. Preventive & Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Thulasingam Mahalakshmy

Authors
  1. Ramanan Sinduja
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  2. Amaranathan Anandhi
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  3. Sathasivam Sureshkumar
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  4. Deepak Barathi
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  5. Thulasingam Mahalakshmy
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  6. Vikram Kate
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Contributions

Ramanan Sinduja: data collection; formal analysis; investigation; writing—original draft. Amaranathan Anandhi: conceptualization; supervision; writing—review and editing. Sathasivam Sureshkumar: supervision; writing—review and editing. Deepak Barathi: methodology; validation; writing—review and editing. Thulasingam Mahalakshmy: formal analysis; supervision; writing—review and editing. Vikram Kate: conceptualization; formal analysis; supervision; validation; writing—review and editing.

Corresponding author

Correspondence to Vikram Kate.

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Ethics Approval

Institute Human Ethics Committee (IEC) approval (JIP/IEC/2018/0192) was obtained. All ethical principles mentioned in the Declaration of Helsinki were followed in this study.

Consent to Participate

Informed consent was obtained from the patients before recruitment.

Consent for Publication

Informed consent for publication was obtained from the patients before recruitment.

Conflict of Interest

The authors declared no competing interests.

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Sinduja, R., Anandhi, A., Sureshkumar, S. et al. Role of Sarcopenia in Predicting the Postoperative Morbidity and Perioperative Mortality in Patients Undergoing Elective Surgery for Gastric Cancer. J Gastrointest Canc 53, 939–947 (2022). https://doi.org/10.1007/s12029-021-00715-w

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  • DOI: https://doi.org/10.1007/s12029-021-00715-w

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