Impact of preoperative sarcopenia on morbidity in gastric cancer surgery.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 40-40
Author(s):  
Tsutomu Sato ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Haruhiko Cho ◽  
Taiichi Kawabe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Risk Factor ◽  
Grip Strength ◽  
Muscle Mass ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
Hand Grip

40 Background: Skeletal muscle depletion, known as sarcopenia, is characterized by decrease in muscle mass and function. Recent reports demonstrated that sarcopenia was a significant risk factor for complications in colorectal cancer surgery. This study aimed to evaluate impact of preoperative sarcopenia on morbidity in gastric cancer surgery. Methods: Between May 2011 and June 2013, 293 consecutive primary gastric cancer patients who underwent curative surgery were retrospectively examined. All patients received the same perioperative care of enhanced recovery after surgery program. Preoperative skeletal muscle mass was evaluated by bioelectrical impedance analysis and was expressed as skeletal muscle index or SMI (muscle mass/height2) by adjusting absolute muscle mass with height. Preoperative muscle function was measured by hand grip strength (HGS). Each cutoff value was determined as the gender-specific lowest 20% of the distribution of each measurement. Grade 2 or higher morbidity, evaluated by Clavien-Dindo classification, was picked-up from the patient record. Risk factor for morbidity was examined by uni- and multi-variate analyses. Results: Median age (range) was 68 years (37-85 years). Male to female ratio was 192:101. Operative procedure was 122 total, 169 distal, and 2 proximal gastrectomy. Lymphadenectomy was 162 D1+ and 131 D2 including 53 splenectomy. Pathological stage was I in 149, II in 39, III in 91, and IV in 14 patients. Morbidity included 7 pancreatic leakage, 12 anastomotic leakage, 4 intra-abdominal abscess, and others. In total, morbidity was observed in 39 patients (13.3%); 21 in grade 2, 16 in grade 3a, 1 in grade 3b, and 1 in grade 4. No mortality was observed. Univariate analysis showed that male, total gastrectomy, splenectomy, and low HGS were significant risk factor for morbidity. Low SMI was not a risk factor. By multi-variate analysis, low HGS(HR 2.457, p=0.029), male(HR 2.610, p=0.038)and total gastrectomy(HR 2.747, p=0.027)remained significant. Conclusions: Low hand grip strength was one of significant risk factor for morbidity in gastric cancer surgery. Hand grip strength as a surgical risk has a value to be examined in the future prospective studies.

Impact of preoperative sarcopenia on recurrecnce in gastric cancer surgery.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 120-120
Author(s):  
Tsutomu Sato ◽  
Toru Aoyama ◽  
Yukio Maezawa ◽  
Kazuki Kano ◽  
Kenki Segami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Risk Factor ◽  
Muscle Mass ◽  
Significant Risk ◽  
Cancer Surgery ◽  
Pathological Stage ◽  
Gastric Cancer Surgery ◽  
Negative Prognostic Factor

120 Background: Our previous study clarified that morbidity was a negative prognostic factor and sarcopenia defined by of the handgrip strength was a risk factor for the morbidity in gastric cancer surgery. Sarcopenia was reportedly a negative prognostic factor in colorectal cancer, hepatocellular carcinoma and malignant melanoma. This study aimed to evaluate impact of preoperative sarcopenia on recurrence-free survival (RFS) in gastric cancer surgery. Methods: Between May 2011 and June 2013, 256 consecutive primary gastric cancer patients who underwent curative surgery were retrospectively examined. Patients who received neoadjuvant chemotherapy or were diagnosed with pathological stage IV were excluded. Preoperative skeletal muscle mass was evaluated by bioelectrical impedance analysis and was expressed as skeletal muscle index or SMI (muscle mass/height2) by adjusting absolute muscle mass with height. Preoperative muscle function was measured by hand grip strength (HGS). Each cutoff value was determined as the gender-specific lowest 20% of the distribution of each measurement. Univariate and multivariate analyses were preformed to identify risk factors for RFS using a Cox proportional hazards model. Results: Median age (range) was 66 years (37-85 years). Male to female ratio was 168:88. Median follow-up period was 33.4 months. Pathological stage was I in 160, II in 48 and III in 48 patients. Univariate analysis showed that age, adjuvant chemotherapy, pT, pN, histological type, tumor size, total gastrectomy, low SMI and low HGS were significant risk factors for RFS. Multi-variate Cox’s proportional hazard analyses demonstrated that pT (HR 2.76, p = 0.0001), pN (HR 1.375, p = 0.037), histological type (HR 3.46, p = 0.014), low SMI (HR2.17, p = 0.036) were the significant risk factors for RFS. The three-year RFS was 89.1% in the patients with high SMI and 73.2% in those with low SMI (p = 0.007). Conclusions: Low SMI was an independent risk factor for RFS in Stage I-III gastric cancer. Low HGS, a risk factor for morbidity shown in our previous study, was not a risk independent factor for RFS. Preoperative sarcopenia as the short- and long-term outcomes has a value to be tested in the future prospective studies in gastric cancer surgery.

scholarly journals Impact of preoperative hand grip strength on morbidity following gastric cancer surgery

2015 ◽  
Vol 19 (3) ◽  
pp. 1008-1015 ◽  
Author(s):  
Tsutomu Sato ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Kenki Segami ◽  
Taiichi Kawabe ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Grip Strength ◽  
Hand Grip Strength ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
Hand Grip

scholarly journals The difference of risk factor for gastric cancer surgery between elderly and non-elderly patients

2018 ◽  
Vol 29 ◽  
pp. viii233
Author(s):  
T. Hayashi ◽  
T. Oshima ◽  
K. Hara ◽  
Y. Shimoda ◽  
M. Nakazono ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Elderly Patients ◽  
Cancer Surgery ◽  
Gastric Cancer Surgery ◽  
The Difference

scholarly journals Association of Sarcopenic Dysphagia with Underlying Sarcopenia Following Hip Fracture Surgery in Older Women

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1365 ◽  
Author(s):  
Ayano Nagano ◽  
Keisuke Maeda ◽  
Akio Shimizu ◽  
Shinsuke Nagami ◽  
Naohide Takigawa ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Hip Fracture ◽  
Grip Strength ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Oral Intake ◽  
Hip Fracture Surgery ◽  
Hand Grip ◽  
Sarcopenic Dysphagia ◽  
Fracture Surgery

This study aimed to investigate the association between the development of dysphagia in patients with underlying sarcopenia and the prevalence of sarcopenic dysphagia in older patients following surgical treatment for hip fracture. Older female patients with hip fractures (n = 89) were studied. The data of skeletal muscle mass, hand-grip strength, and nutritional status were examined. The development of dysphagia postoperatively was graded using the Food Oral Intake Scale by a certified nurse in dysphagia nursing. The patients’ mean age was 85.9 ± 6.5 years. The prevalence of sarcopenia was 76.4% at baseline. Of the 89 patients, 11 (12.3%) and 12 (13.5%) had dysphagia by day 7 of hospitalization and at discharge, respectively. All patients who developed dysphagia had underlying sarcopenia. Lower skeletal muscle mass index (SMI) (<4.7 kg/m2) and grip strength (<8 kg) at baseline indicated a higher incidence of dysphagia on day 7 (p = 0.003 and Phi = 0.391) and at discharge (p = 0.001 and Phi = 0.448). Dysphagia developed after hip fracture surgery could be sarcopenic dysphagia, and worsening sarcopenia was a risk factor for dysphagia following hip fracture surgery. Clinicians and medical coworkers should become more aware of the risks of sarcopenic dysphagia. Early detection and preventive interventions for dysphagia should be emphasized.

Incidence and risk factors of thromboembolism (TE) in advanced gastric cancer (AGC) receiving chemotherapy: A prospective observational study (NCT01047618).

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 31-31
Author(s):  
Baek-Yeol Ryoo ◽  
Min-Hee Ryu ◽  
Sook Ryun Park ◽  
Myoung Joo Kang ◽  
Kwon-Oh Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Incidence Rate ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Limited Information ◽  
Vein Thrombosis ◽  
Gastric Cancer Patients ◽  
D Dimer

31 Background: The incidence of TE in gastric cancer patients (pts) is known to be high. But because the previous reports were retrospectively analyzed in heterogeneous population, they give us only limited information. We therefore conducted a prospective study to investigate the incidence of TE and prognostic factors related with TE in AGC pts receiving chemotherapy. Methods: We checked D-dimer and coagulation battery at the start of chemotherapy and every 3 months thereafter. If there developed symptoms or signs of TE, or if D-dimer elevated 5 μg/mL or more we checked imaging studies to detect TE. The chemotherapy regimen mainly included fluoropyrimidine plus platinum-based for 1st-line, taxane-based for 2nd-line, and irinotecan-based for 3rd-line chemotherapy. Results: Between Nov 2009 and Apr 2012, 241 pts were analyzed. They received median 9 (range 1 - 42) cycles of chemotherapy. During the median observational duration of 16.7 months, 32 events (13.3%, 95% CI; 8.9 - 17.7%) of TE were detected. The types of TE were as follows; deep vein thrombosis (DVT) only in 18 (56.3%), pulmonary embolism (PE) only in 4 (12.5%), DVT and PE in 5 (15.6%), cerebral infarction in 4 (12.5%), and intra-abdominal arterial thrombosis 1 (3.1%) pts. The 1-year and 2-year cumulative incidences of TE were 15.0% (95% CI, 9.6 - 20.0%) and 20.0% (95% CI, 12.1 - 26.9%), respectively. The incidence rate of TE was 14.1 (95% CI, 9.6 - 19.9) events/100 person-years. In univariate analysis, the previous gastrectomy history, baseline CA72-4 level and baseline D-dimer level were statistically significant risk factor related with TE development. But in multivariate analysis, baseline D-dimer level was the only independent risk factor associated with TE development (Hazard ratio 2.46 [95% CI, 1.08 - 5.63], P= 0.033). Among 32 pts with baseline D-dimer 5.0 μg/mL or higher, 8 pts (25.0%) developed TE, while for pts whose baseline D-dimer was lower than 5.0 μg/mL, 24 out of 209 pts (11.5%) developed TE. Conclusions: The incidence rate of TE in AGC pts receiving chemotherapy was 14.1 (95% CI, 9.6 - 19.9) events/100 person-years. D-dimer was an important prognostic factor related with TE development. Clinical trial information: NCT01047618.

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