P-77 Risk factors and clinical outcomes of post-gastrectomy sarcopenia newly developed after curative resection for gastric cancer

Abstract

Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength. GC is among the most common causes of sarcopenia. Sarcopenia is an independent predictor of postsurgical outcomes, including various postoperative complications, and shortened overall survival (OS) in many gastrointestinal cancers, including GC. This may arise because patients with sarcopenia generally have a poor nutritional status. Therefore, nutritional status should be an important prognostic factor in patients with GC postoperatively. Sarcopenia predicted the 1-year mortality in elderly patients undergoing GC surgery. Thus, knowing whether newly developed sarcopenia after surgical resection increases the risk of poor outcomes is meaningful for clinical practice because it may provide new nutritional intervention ideas to achieve better prognosis among patients with GC. However, there is a lack of research on newly developed sarcopenia postoperatively. Therefore, this study aimed to investigate the risk factors and clinical impact of post-gastrectomy sarcopenia newly developed after surgical resection on the prognosis of patients undergoing curative gastrectomy for GC. The clinicopathological data of 573 consecutive patients with GC who underwent curative gastrectomy were reviewed. Skeletal muscle mass and abdominal fat volume were measured using abdominal CT. Forty-six (8.0%) patients were diagnosed with preoperative sarcopenia. Among the 527 patients without sarcopenia, 57 (10.8%) were diagnosed with post-gastrectomy sarcopenia newly developed 1 year after curative gastrectomy. Female sex, weight loss, proximal location of the tumor, and differentiated tumor were significant risk factors of post-gastectomy sarcopenia newly developed after curative gastrectomy. There was a significant difference in the 5-year overall survival among the preoperative sarcopenic, non-sarcopenic, and post-gastrectomy sarcopenic groups (P = .017). Especially, there was a significant difference between non-sarcopenic and post-gastrectomy sarcopenic groups (P = .009). However, there was no significant difference in the 5-year disease-free survival among the groups (P = .49). Since newly developed sarcopenia after surgical resection had an influence on overall survival, patients with high sarcopenia risks after curative gastrectomy may require early nutritional support.