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Predictive Value of Preoperative Sarcopenia in Patients with Gastric Cancer: a Meta-analysis and Systematic Review

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

The impact of preoperative sarcopenia on postoperative complications and overall survival has been recently debated. Our meta-analysis aims to ascertain whether preoperative sarcopenia increases the risk of poor outcomes and to attempt to provide new ideas for the prognosis of outcomes for patients with gastric cancer.

Methods

We searched for all relevant articles on PubMed, the EMBASE database, and Web of Science (up to September 1, 2017). Data synthesis and statistical analysis were carried out using RevMan 5.3 software.

Results

Thirteen studies involving 4262 patients who underwent gastrectomy for gastric cancer were analyzed (sarcopenia group = 1234; non-sarcopenia group = 3028). The results showed that preoperative sarcopenia significantly associated with poor pathological staging (high pT: OR = 1.86, 95% CI = 1.49–2.31; P < 0.01; pN+: OR = 1.61, 95% CI = 1.33–1.94; P < 0.01; high TNM category: OR = 1.84, 95% CI = 1.53–2.22; P < 0.01). Patients with preoperative sarcopenia had an increased risk of total postoperative complications (OR = 2.17, 95% CI = 1.53–3.08; P < 0.01), severe complications (OR = 1.65, 95% CI = 1.09–2.50; P = 0.02), and poorer OS (HR = 1.70, 95% CI = 1.45–1.99; P < 0.01). The results of subgroup analyses revealed that patients with preoperative sarcopenia over 65 years old and those from Asian populations had higher risks for total postoperative complications and severe complications.

Conclusion

This meta-analysis reveals that preoperative sarcopenia may be used as a new indicator of poor pathological staging, impaired overall survival, and increased postoperative complications. Notably, patients with gastric cancer who are over 65 years old and from Asia should be routinely screened for sarcopenia before surgery to adequately assess the risk of postoperative complications in clinical practice.

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Acknowledgements

We thank the department of Surgical Oncology of First Hospital of China Medical University for technical assistance in this analysis.

Funding

This study was funded by Key Laboratory Grant of Education Department of Liaoning Province (grant number LS201602).

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  1. Zhengdao Yang and Xin Zhou contributed equally to this work.

Authors and Affiliations

  1. Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang, 110001, China

    Zhengdao Yang, Bin Ma, Yanan Xing, Xue Jiang & Zhenning Wang

  2. Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110001, China

    Xin Zhou

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Contributions

Study concepts: Yanan Xing

Study design: Zhengdao Yang; Yanan Xing

Data acquisition: Zhengdao Yang; Xin Zhou

Quality control of data and algorithms: Bin Ma

Data analysis and interpretation: Zhengdao Yang; Xin Zhou

Manuscript preparation: Zhengdao Yang; Xin Zhou

Manuscript review: Xue Jiang; Zhenning Wang

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Correspondence to Yanan Xing.

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Yang, Z., Zhou, X., Ma, B. et al. Predictive Value of Preoperative Sarcopenia in Patients with Gastric Cancer: a Meta-analysis and Systematic Review. J Gastrointest Surg 22, 1890–1902 (2018). https://doi.org/10.1007/s11605-018-3856-0

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