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We aimed to establish the effects of sarcopenia on postoperative complications among patients undergoing surgical treatment for gastric cancer
Among gastrointestinal disease, gastric cancer is a malignancy which is diagnosed predominantly in advanced stages, mostly accompanied with malnutrition when diagnosed, has aggressive behavior with poor oncological outcomes. The only option for curative treatment is surgical resection in this malignancy; however, the surgical procedure itself causes high morbidity and mortality rates. Therefore, physicians combine various treatment modalities and risk assessment to decrease complication and mortality rates.
Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death. For the diagnosis of sarcopenia, using the presence of both low muscle mass and decreased muscle function (strength or performance) is recommended. Previous studies showed that colorectal or pancreatic cancer accompanied with sarcopenia has adverse effects on not only for short term and also for long term outcomes. The majority of studies regarding gastric cancer was published from Eastern countries owing to their high incidence. There are few studies from western countries which are mostly retrospective and does not meet the diagnostic criteria of sarcopenia. In the western population, there is no high-quality evidence so far regarding the impact of sarcopenia on early outcomes of gastric cancer surgical treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Participants with gastric cancer | All consecutive patients undergoing surgery due to gastric cancer will be included in this study. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | No intervention is planned for the participants for the treatment of gastric cancer. Treatment decision will be in line with clinical practice guidelines. Surgical team will be blind to the participant's sarcopenia status. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complications | complications graded by Clavien-Dindo Complication Classification System | within 30 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | time interval from the date of operation to the date of discharge | up to 90 days |
| Mortality | Dying after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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All consecutive patients undergoing surgery due to gastric cancer will be included in this study.
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| Name | Affiliation | Role |
|---|---|---|
| Ali GUNER, MD | Karadeniz Technical University Faculty of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karadeniz Technical University, Faculty of Medicine | Trabzon | 61080 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20392703 | Background | Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010 Jul;39(4):412-23. doi: 10.1093/ageing/afq034. Epub 2010 Apr 13. | |
| 26407875 |
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| ID | Term |
|---|---|
| D013274 | Stomach Neoplasms |
| D055948 | Sarcopenia |
| D044342 | Malnutrition |
| D002100 | Cachexia |
| D009369 | Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
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| within 30 days after surgery |
| Readmission rate | readmission to the hospital because of the adverse events after discharge | within 30 days after surgery |
| Incidence of sarcopenia | Sarcopenia consensus defined by The European Working Group on Sarcopenia in Older People | one day before surgery |
| Muscle mass volume | muscle mass volume of a cross-sectional computerized- tomography image of the L3, corrected for patient height resulting in L3 muscle index. | one day before surgery |
| Psoas muscle mass volume | muscle mass volume of Psoas muscle with 3D reconstruction | one day before surgery |
| Muscle strength | evaluated by handgrip strength test (with digital dynamometer) | one day before surgery |
| Physical performance | evaluated by 4-meter gait speed test | one day before surgery |
| Major complication | grade 3 or higher complications graded by Clavien-Dindo Complication Classification System | within 30 days after surgery |
| Background |
| Fukuda Y, Yamamoto K, Hirao M, Nishikawa K, Nagatsuma Y, Nakayama T, Tanikawa S, Maeda S, Uemura M, Miyake M, Hama N, Miyamoto A, Ikeda M, Nakamori S, Sekimoto M, Fujitani K, Tsujinaka T. Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy. Gastric Cancer. 2016 Jul;19(3):986-93. doi: 10.1007/s10120-015-0546-4. Epub 2015 Sep 25. |
| 26331988 | Background | Tegels JJ, van Vugt JL, Reisinger KW, Hulsewe KW, Hoofwijk AG, Derikx JP, Stoot JH. Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes. J Surg Oncol. 2015 Sep;112(4):403-7. doi: 10.1002/jso.24015. Epub 2015 Aug 31. |
| 28529985 | Background | Guner A. Recent trends of gastric cancer treatment in Turkey. Transl Gastroenterol Hepatol. 2017 Apr 26;2:31. doi: 10.21037/tgh.2017.04.01. eCollection 2017. |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D015431 | Weight Loss |
| D001836 | Body Weight Changes |
| D001835 | Body Weight |
| D013851 | Thinness |