title: Sarcopenia Adversely Impacts Postoperative Clinical Outcomes Following Gastrectomy in Patients with Gastric Cancer: A Prospective Study.
abstract: BACKGROUND
  Sarcopenia is characterized by decreased skeletal muscle plus low muscle strength and/or physical performance. This study was performed to determine the association of sarcopenia with short-term postoperative outcomes after gastrectomy for gastric cancer.
  
  
  METHODS
  We conducted a prospective study of 255 consecutive patients with gastric cancer who underwent curative gastrectomy. The sarcopenia elements, including lumbar skeletal muscle index, handgrip strength, and gait speed, were measured before surgery. Patients were followed up after gastrectomy to gain the actual clinical outcomes. Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis.
  
  
  RESULTS
  Sarcopenia was present in 32 of 255 patients (12.5 %), and was significantly correlated with advance age, lower body mass index, higher nutritional risk screening (NRS) 2002 score, and lower preoperative serum albumin and hemoglobin. Compared with non-sarcopenic patients, sarcopenic patients had a higher risk of postoperative complications, longer postoperative hospital stay, and more hospital costs. In univariate analysis, sarcopenia (p < 0.001), nutritional risk (NRS 2002 score ≥3; p = 0.003), advanced age (≥75 years; p = 0.014), anemia (p = 0.012), hypoalbuminemia (p = 0.029), and diabetes (p = 0.014) were associated with postoperative complications. Multivariable analysis revealed that sarcopenia (p < 0.001) and diabetes (p = 0.006) were independent predictors of postoperative complications.
  
  
  CONCLUSIONS
  Sarcopenia is an independent predictor of postoperative complications in patients with gastric cancer after gastrectomy.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Su-Lin
authors.initials: SL
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Cheng-Le
authors.initials: CL
authors.lastname: Zhuang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Dong-Dong
authors.initials: DD
authors.lastname: Huang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Wen-Yang
authors.initials: WY
authors.lastname: Pang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Neng
authors.initials: N
authors.lastname: Lou
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Fan-Feng
authors.initials: FF
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Chong-Jun
authors.initials: CJ
authors.lastname: Zhou
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. shenxian5166@126.com.
authors.forename: Xian
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. yuzhen0577@gmail.com.|Department of Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China. yuzhen0577@gmail.com.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Yu
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications*; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*