Effects of Sarcopenia, Myosteatosis, and the Prognostic Nutritional Index on Survival in Stage 2 and 3 Gastric Cancer Patients

Nutr Cancer. 2023;75(1):368-375. doi: 10.1080/01635581.2022.2121845. Epub 2022 Sep 10.

Abstract

Background: We aimed to evaluate the relationship between sarcopenia, myosteatosis, and systemic inflammatory response biomarkers and their prognostic role in stage 2 and 3 gastric cancer patients.

Methods: This study included 84 patients with stage 2 or 3 gastric cancer who underwent a gastrectomy. Computed tomography scans were used to determine the skeletal muscle index (SMI) at the third lumbar vertebra level for sarcopenia and myosteatosis.

Results: Based on the Asian Working Group of Sarcopenia (AWGS2019) criteria, the sarcopenia incidence was 36.9% and that of myosteatosis 46.4%. Univariate analysis showed that sarcopenia (48 vs. 14 mo, p < 0.001), myosteatosis (45 vs. 16 mo, p = 0.016), a low prognostic nutritional index (60 vs. 15 mo, p = 0.003), stage 3 (104 vs. 21 mo, p = 0.013), and old age (45 vs. 16 mo, p = 0.015) were poor prognostic markers. Multivariate analysis revealed that sarcopenia (AWGS2019), age, and stage significantly affected overall survival (hazard ratio: 3.31, 95% CI: 1.85-5.1; 1.96, 95% CI: 1.06-6.63; 2.5, 95% CI: 1.2-5.1, respectively).

Conclusion: We showed that sarcopenia directly affects overall gastric cancer survival.

MeSH terms

  • Gastrectomy / adverse effects
  • Humans
  • Muscle, Skeletal / pathology
  • Nutrition Assessment
  • Prognosis
  • Retrospective Studies
  • Sarcopenia* / epidemiology
  • Sarcopenia* / etiology
  • Stomach Neoplasms* / complications
  • Stomach Neoplasms* / surgery