SARCOPENIA IN GASTRIC CANCER AND BODY COMPOSITION CHANGES AFTER GASTRECTOMY

• Autor(a) principal: Ferreira, Margarida
• Data de Publicação: 2022
• Outros Autores: Barreira, Ana Lúcia, Sardinha, Francisco, Costa, João, Rodrigues, Jéssica, Gonçalves, Afonso, Matos Costa, Paulo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.34635/rpc.883

Sarcopenia is the phenomenon of loss of muscle strength, muscle performance and muscle mass due to either age (primary sarcopenia) or other illnesses such as cancer (secondary sarcopenia). Sarcopenia has often been defined in the literature as low muscle mass. Sarcopenia among gastric cancer patients has been shown to carry a higher risk of post-operative complications and a higher overall and disease-specific mortality. Our study included 86 patients who underwent surgery for gastric cancer at our institution. Muscle mass was assessed by CT scan (L3 Muscle Index). A subgroup analysis was then performed of 39 patients who had had CT scans 12 months postoperatively. We collected demographic, clinical and body composition data. Sarcopenia was defined by the L3 Muscle Mass Index according to cut-off values previously defined in the literature. We found a prevalence of sarcopenia of 40.7% among gastric cancer patients undergoing gastrectomy. Sarcopenia was associated with a higher overall mortality. Nutritional risk and percentage of body weight lost did not identify sarcopenic patients. 51.4% of sarcopenic patients were overweight, 2.9% were obese. At 12 months post-operatively, 82.1% of patients lost weight and BMI and 76.9% of patients lost muscle mass (lower L3 muscle index) after gastrectomy. We did not find a significant association between the change in muscle mass, BMI or weight. We found that total gastrectomy was significantly associated to muscle mass loss compared to subtotal gastrectomy. We also found a significant association between advanced gastric cancer stage and muscle mass loss. We concluded that while sarcopenia is highly prevalent among gastric cancer patients after gastrectomy, the vast majority of patients lose weight and muscle mass. Since most patients will not improve muscle mass postoperatively it is crucial to implement prehabilitation strategies early on.