Impact of preoperative sarcopenia on postoperative complications and prognosis in patients undergoing robotic gastric cancer surgery: A propensity score matching study.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Elsevier Science Country of Publication: United States NLM ID: 8802712 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1244 (Electronic) Linking ISSN: 08999007 NLM ISO Abbreviation: Nutrition Subsets: MEDLINE
    • Publication Information:
      Publication: Tarrytown, NY : Elsevier Science
      Original Publication: [Burbank, Calif. : Nutrition, c1987-
    • Subject Terms:
      Sarcopenia*/etiology ; Stomach Neoplasms*/surgery ; Stomach Neoplasms*/complications ; Propensity Score* ; Gastrectomy*/adverse effects ; Gastrectomy*/methods ; Postoperative Complications*/epidemiology ; Postoperative Complications*/etiology ; Robotic Surgical Procedures*/methods ; Robotic Surgical Procedures*/adverse effects; Humans ; Male ; Female ; Retrospective Studies ; Aged ; Middle Aged ; Prognosis ; Preoperative Period ; Length of Stay/statistics & numerical data
    • Abstract:
      Background: Sarcopenia, defined as decreased muscle mass and function, correlates with postoperative morbidity and mortality in cancer surgery. However, sarcopenia's impact specifically following robotic gastrectomy for gastric cancer has not been clearly defined. This study aimed to determine the influence of sarcopenia on short- and long-term clinical outcomes after robotic gastrectomy for gastric cancer.
      Methods: This retrospective study analyzed 381 gastric cancer patients undergoing robotic gastrectomy. Sarcopenia was diagnosed by preoperative computed tomography (CT) body composition analysis. Propensity score matching created 147 pairs of sarcopenia and nonsarcopenia patients for comparison. Outcomes included postoperative complications, survival, inflammatory markers, length of stay, intensive care unit (ICU) transfer, and readmissions.
      Results: Sarcopenia patients exhibited significantly higher rates of overall (53.7% versus 21.1%, P < 0.001), serious (12.9% versus 4.1%, P = 0.007), and grade III-IV complications compared to nonsarcopenia pairs after matching. Sarcopenia independently predicted reduced 3-years overall (HR = 2.53, 95% CI: 1.19-5.40, P = 0.016) and disease-free survival (HR = 1.99, 95% CI: 1.09-3.66, P = 0.026). Sarcopenia patients also showed heightened postoperative leukocyte, neutrophil, platelet, platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and monocyte to lymphocyte ratio (MLR) levels alongside suppressed lymphocytes, monocytes, and neutrophil to lymphocyte ratio (NLR).
      Conclusion: Preoperative sarcopenia is correlated with increased postoperative complications and poorer long-term survival in gastric cancer patients undergoing robotic gastrectomy. Sarcopenia assessment can optimize preoperative risk stratification and perioperative management in this population.
      Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
      (Copyright © 2024 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Gastric cancer; Postoperative complications; Prognosis; Propensity score matching; Robotic surgery; Sarcopenia
    • Publication Date:
      Date Created: 20240321 Date Completed: 20240510 Latest Revision: 20240510
    • Publication Date:
      20240511
    • Accession Number:
      10.1016/j.nut.2024.112408
    • Accession Number:
      38513525