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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2017

01-07-2017 | Gastrointestinal Oncology

Prognostic Significance of Sarcopenia in Patients with Esophagogastric Junction Cancer or Upper Gastric Cancer

Authors: Kensuke Kudou, MD, Hiroshi Saeki, MD, PhD, FACS, Yuichiro Nakashima, MD, PhD, Keitaro Edahiro, MD, Shotaro Korehisa, MD, Daisuke Taniguchi, MD, Ryosuke Tsutsumi, MD, Sho Nishimura, MD, Yu Nakaji, MD, Shingo Akiyama, MD, Hirotada Tajiri, MD, Ryota Nakanishi, MD, PhD, Junji Kurashige, MD, PhD, Masahiko Sugiyama, MD, PhD, Eiji Oki, MD, PhD, FACS, Yoshihiko Maehara, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 7/2017

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Abstract

Background

The association between sarcopenia and postoperative outcomes for patients with gastrointestinal malignancies remains controversial. This study aimed to assess the impact of sarcopenia on short- and long-term outcomes after surgery for esophagogastric junction cancer (EGJC) or upper gastric cancer (UGC).

Methods

The study reviewed 148 patients with EGJC or UGC who underwent surgical resection. The patients were categorized into the sarcopenia group or the non-sarcopenia group according to their skeletal muscle index calculated using abdominal computed tomography images. The study compared clinicopathologic factors, postoperative complications, and prognosis between the two groups.

Results

Sarcopenia was present in 19 patients (32.2%) with EGJC and 23 patients (25.8%) with UGC. The 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly poorer in the sarcopenia group than in the non-sarcopenia group (OS 85.5 vs 54.8%, P = 0.0010; RFS 78.7 vs 51.7%, P = 0.0054). The development of postoperative complications did not differ significantly between the two groups. Both the uni- and multivariate analyses showed that N stage (P < 0.0001) and sarcopenia (P = 0.0024 and 0.0293, respectively) were independent poor prognostic factors for OS.

Conclusions

Sarcopenia was strongly associated with a poor long-term prognosis for patients with EGJC or UGC who underwent surgery. The results suggest that special attention might be needed during the development of treatment strategies for patients with sarcopenia who intend to undergo operations for EGJC and UGC.
Appendix
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Metadata
Title
Prognostic Significance of Sarcopenia in Patients with Esophagogastric Junction Cancer or Upper Gastric Cancer
Authors
Kensuke Kudou, MD
Hiroshi Saeki, MD, PhD, FACS
Yuichiro Nakashima, MD, PhD
Keitaro Edahiro, MD
Shotaro Korehisa, MD
Daisuke Taniguchi, MD
Ryosuke Tsutsumi, MD
Sho Nishimura, MD
Yu Nakaji, MD
Shingo Akiyama, MD
Hirotada Tajiri, MD
Ryota Nakanishi, MD, PhD
Junji Kurashige, MD, PhD
Masahiko Sugiyama, MD, PhD
Eiji Oki, MD, PhD, FACS
Yoshihiko Maehara, MD, PhD, FACS
Publication date
01-07-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 7/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5811-9

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