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Cachexia Versus Sarcopenia in Clinical Characteristics and Prognostic Value After Radical Gastrectomy for Gastric Cancer: A Large-Scale Prospective Study

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Sarcopenia and cachexia are two predictors of adverse clinical outcomes, but they are partly overlapping. We aimed to compare the characteristics and prognostic value of cachexia and sarcopenia in patients after gastrectomy.

Methods

From 2014 to 2019, a total of 1215 gastric cancer patients were enrolled. Cachexia and sarcopenia were diagnosed according to the most recent consensus definitions. Baseline characteristics and clinical outcomes were compared between the two groups. Risk factors of survival were evaluated by Cox regression analysis.

Results

Of all patients, 26.5% were diagnosed with cachexia and 19.8% were diagnosed with sarcopenia. Sarcopenia was more prevalent in elderly patients, while cachexia was prone to occur in patients with TMN stage III. Survival curves showed that sarcopenia had adverse effects in patients with TMN stage I and II–III, while cachexia was only associated with poor survival at stages II–III. For the entire cohort, both cachexia and sarcopenia were adverse factors for prognosis. However, for stage I patients, sarcopenia was an independent predictor for overall survival (OS) (HR = 4.939, P < 0.001) and disease-free survival (DFS) (HR = 4.256, P < 0.001), but not cachexia; for stage II–III patients, cachexia was an independent predictor for OS (HR = 1.538, P < 0.001) and DFS (HR = 1.473, P = 0.001), but not sarcopenia.

Conclusions

Sarcopenia and cachexia have different clinical characteristics and prognostic values. For patients with early stage gastric cancer, detection for sarcopenia was more meaningful than cachexia. However, the prognostic significance of cachexia exceeded sarcopenia in advanced cancer.

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Acknowledgments

We thank the study participants and their families, whose help and participation made this work possible.

Funding

This work was supported by the National Key Research and Development Program: The National Natural Science Foundation of China (No. 81800795, 81770884), Shanghai Municipal Commission of Health and Family Planning (No.20184Y0301), the Key Technology of Palliative Care and Nursing for Cancer Patients (2017YFC1309200), the Zhejiang Provincial Health Department Medical Support Discipline—Nutrition (11-ZC24), the Wenzhou Municipal Science and Bureau (Y2020732).

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Author notes

  1. Cheng-Le Zhuang and Qian-Tong Dong contributed equally to the work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou, China

    Xin Luo MD, Wen-Bin Wang MD, Xiao-Lei Chen MD & Su-Lin Wang MD

  2. Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

    Cheng-Le Zhuang PhD, Feng-Min Zhang MD & Zhen Yu PhD

  3. Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

    Han-Ping Shi PhD

  4. Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China

    Qian-Tong Dong MD

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  1. Cheng-Le Zhuang PhD
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Correspondence to Xiao-Lei Chen MD or Su-Lin Wang MD.

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Zhuang, CL., Dong, QT., Shi, HP. et al. Cachexia Versus Sarcopenia in Clinical Characteristics and Prognostic Value After Radical Gastrectomy for Gastric Cancer: A Large-Scale Prospective Study. Ann Surg Oncol 29, 2348–2358 (2022). https://doi.org/10.1245/s10434-021-11084-w

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