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

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Disclosure

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    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

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  1. Kensuke Kudou MD
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  2. Hiroshi Saeki MD, PhD, FACS
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  12. Ryota Nakanishi MD, PhD
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  14. Masahiko Sugiyama MD, PhD
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  15. Eiji Oki MD, PhD, FACS
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  16. Yoshihiko Maehara MD, PhD, FACS
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Corresponding author

Correspondence to Hiroshi Saeki MD, PhD, FACS.

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Supplementary material 1 (DOCX 24 kb)

10434_2017_5811_MOESM2_ESM.tif

SUPPLEMENTARY FIG. 1 Postoperative outcomes for patients with esophagogastric junction cancer (EGJC) or upper gastric cancer (UGC). A Recurrence-free survival (RFS) of all the study patients. B Overall survival (OS) of all the study patients (n = 142). The 5-year RFS and OS rates tended to be worse for the patients with EGJC (P = 0.1284) than for those with UGC (P = 0.0788). Supplementary material 2 (TIFF 88 kb)

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Kudou, K., Saeki, H., Nakashima, Y. et al. Prognostic Significance of Sarcopenia in Patients with Esophagogastric Junction Cancer or Upper Gastric Cancer. Ann Surg Oncol 24, 1804–1810 (2017). https://doi.org/10.1245/s10434-017-5811-9

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  • DOI: https://doi.org/10.1245/s10434-017-5811-9

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