New-Onset Postoperative Sarcopenia After Gastrectomy Predicts Long-Term Prognosis in Gastric Cancer Patients.

Abstract

Sarcopenia is a risk factor for increased postoperative complications and shortened survival. Although gastrectomy increases the risk for the development of postoperative sarcopenia, the association between postoperative sarcopenia after gastrectomy and long-term survival remains unclear. In this study, changes in body composition before and after gastrectomy were analyzed using bioelectrical impedance analysis to evaluate their association with prognosis. A single-center, retrospective cohort study of radical surgery for gastric cancer, performed at Teine Keijinkai Hospital between January 2018 and December 2023, was conducted. The association of preoperative and newly developed sarcopenia with long-term survival after gastrectomy was examined. Of 328 surgical patients, 255 patients for whom data could be acquired were analyzed. Forty-nine patients (19.2%) had sarcopenia preoperatively, and all of these patients still had sarcopenia after gastrectomy. Of the 206 patients who did not have sarcopenia before gastrectomy, 159 remained sarcopenia-free 6 months after gastrectomy, and 47 patients (18.4%) developed sarcopenia after gastrectomy. The preoperative sarcopenia and postoperative sarcopenia groups had significantly shorter overall survival (p < 0.0001 and p = 0.0005, respectively) than those in the nonsarcopenia group. Postoperative sarcopenia was a negative prognostic factor, comparable to preoperative sarcopenia.