Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes.
OBJECTIVE
Aim of this study was to assess the prevalence of sarcopenia and body composition (i.e., subcutaneous and visceral fat) in gastric cancer surgical patients and its association with adverse postoperative outcome.


METHODS
Preoperative CT scans were obtained from all patients who underwent surgery for gastric adenocarcinoma between January 2005 and September 2012. Total muscle and adipose tissue cross-sectional area were measured at the level of the third lumbar vertebra (L3) transverse processes. Sarcopenia was defined according to gender- and body mass index (BMI)-specific cutoff points. Primary outcome was in-hospital mortality. Secondary outcomes were severe postoperative complications (i.e., Clavien-Dindo classification ≥3a complications) and 6-month mortality.


RESULTS
In 152 out of a total of 180 (84.4%) patients, a CT-scan was available for analysis. In total, 86 (57.7%) of the patients were classified as sarcopenic. Sarcopenia was no predictor for in-hospital mortality (P = 0.52), severe complications (P = 1.00) or 6-month mortality (P = 0.69). Intraabdominal and subcutaneous adipose tissue measurements were not associated with in-hospital mortality, severe complications or 6-month mortality.


CONCLUSIONS
In this population of gastric cancer surgical patients, the prevalence of sarcopenia was 57.7%, which is high compared to other abdominal surgical oncology populations. However, sarcopenia was not associated with postoperative morbidity or mortality.
Department of Surgery, Atrium-Orbis Medical Centre, Sittard, The Netherlands.
Juul J W
JJ
Tegels
Department of Surgery, Atrium-Orbis Medical Centre, Sittard, The Netherlands.|Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Jeroen L A
JL
van Vugt
Department of Surgery, Atrium-Orbis Medical Centre, Sittard, The Netherlands.|Department of Surgery, Maastricht University Medical Centre, The Netherlands.|Department of Surgery, Atrium-Orbis Medical Centre, Heerlen, The Netherlands.
Kostan W
KW
Reisinger
Department of Surgery, Atrium-Orbis Medical Centre, Sittard, The Netherlands.|Department of Surgery, Atrium-Orbis Medical Centre, Heerlen, The Netherlands.
Karel W E
KW
Hulsewé
Department of Surgery, Atrium-Orbis Medical Centre, Sittard, The Netherlands.|Department of Surgery, Atrium-Orbis Medical Centre, Heerlen, The Netherlands.
Anton G M
AG
Hoofwijk
Department of Surgery, Maastricht University Medical Centre, The Netherlands.
Joep P M
JP
Derikx
Department of Surgery, Atrium-Orbis Medical Centre, Sittard, The Netherlands.|Department of Surgery, Atrium-Orbis Medical Centre, Heerlen, The Netherlands.
Jan H M B
JH
Stoot
D000230:Adenocarcinoma / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D055948:Sarcopenia / Q000453:epidemiology* / Q000209:etiology; D013274:Stomach Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
body composition; gastric cancer; muscle mass; sarcopenia; surgery