Abstract 168P
Background
Stomach cancer has a poor 5-year survival rate. Sarcopenia worsens outcomes, especially in metastatic cases. This study evaluates sarcopenia's impact on stage 2-3 gastric cancer survival post-surgery and identifies other prognostic factors.
Methods
A retrospective analysis was conducted on 217 stage 2-3 gastric cancer patients who had surgery between January 2011 and December 2017 at Chung-Ang University College of Medicine. Skeletal muscle area, skeletal muscle index (SMI), and subcutaneous fat index (SF) were measured using computed tomography scans. We evaluate the relationship between various indicators (SMI, SF) and overall survival (OS) and disease-free survival (DFS) by cox regression analysis.
Results
Among the 217 patients analyzed, 29.5%(64 patients) presented with sarcopenia at baseline. Post-surgery, the SMI exhibited a significant decrease of 6.02% at 3 months and 5.92% at 12 months, while the decrease between 3-12 months was minimal and not statistically significant. The median OS for the entire cohort was 89.0 months. Notably, patients with baseline sarcopenia had a median OS of 40.0 months, whereas the OS for those without baseline sarcopenia was not determined, indicating a potentially longer survival time(HR 1.930, 95% CI = 1.279-2.911, P=0.001). Multivariate analysis revealed that advanced stage (HR 6.701; 95% CI 3.544-12.671; P<0.001) and decreased 12-month SMI (HR 2.373; 95% CI 1.375-4.095; P=0.002) were significant poor prognostic factors for OS. The median DFS for the cohort was 60.0 months. Patients with baseline sarcopenia had a median DFS of 24.0 months compared to 87.0 months for those without sarcopenia (HR=1.801, 95% CI = 1.218-2.662, P=0.003). In the multivariate analysis for DFS, stage (HR 5.211; 95% CI 2.985-9.096; P<0.001), sarcopenia (HR 1.887; 95% CI 1.168-3.046; P=0.009), and completion of chemotherapy (HR 0.555; 95% CI 0.327-0.941; P=0.029) emerged as significant prognostic factors.
Conclusions
Sarcopenia and post-surgery SMI decline are key predictors of OS and DFS in stage 2-3 gastric cancer patients. Assessing and managing sarcopenia is essential in clinical care to potentially enhance long-term survival.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.