Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients following gastrectomy

Abstract

Sarcopenia is defined as the attenuation of muscle mass and strength that is associated with aging. Sarcopenia is one of the causes of frailty; it is associated with impaired activity of daily life, fracture and poor treatment outcome of various cancers. The aim of this study was to examine the prevalence of sarcopenia among elderly gastric cancer patients and the impact on postoperative complications. Of 69 elderly ( ≥ 65 years old) gastric cancer patients undergoing gastrectomy between July 2012 and February 2014 in our institute, 38 patients (55.1%) were diagnosed with sarcopenia, based on the criteria proposed by European Working Group on Sarcopenia in Older People (EWGSOP). Sarcopenic patients were significantly older (77 vs. 73 years old, p=0.025) and had a lower Body Mass Index (BMI) (20.4 vs. 23.5 kg/m2, p=0.0016), compared to non-sarcopenic patients. In terms of preoperative nutritional intake assessed by a national registered dietitian in our institute using Food Frequency Questionnaire (FFQ), calories and protein of food intake in sarcopenic patients were significantly smaller than that in non-sarcopenic patients [25.6 vs. 29.9 kcal/(IBW)kg, p=0.0060 and 0.95 vs. 1.12 g/(IBW)kg, p=0.0041, respectively]. The incidence of severe postoperative complications greater than Grade Ⅲ a, according to the Clavien-Dindo classification was greater in sarcopenic patients (23.7 vs. 6.5%, p=0.043) and sarcopenia was identified as an independent risk factor of severe complications after gastrectomy from Logistic multivariate regression analysis (odds ratio 5.86, 95% confidence interval 1.06.51.65, p=0.042). Optimal nutritional support has a possible role to improve the short-term treatment outcome after gastrectomy for elderly gastric cancer patients.