Metabolic syndrome-related sarcopenia is associated with worse prognosis in patients with gastric cancer: A prospective study.
OBJECTIVES
Sarcopenia and metabolic syndrome (MetS) are associated with the prognosis from malignant tumors. However, evidence of the relationship between sarcopenia and MetS among gastric cancer (GC) patients following radical gastrectomy is lacking. This study assessed the association between preoperative sarcopenia and MetS among GC patients and analyzed the prognosis of patients with different malnutrition statuses.


METHODS
We prospectively assessed the preoperative statuses of sarcopenia and MetS among patients who underwent radical gastrectomy from July 2014 to December 2017. We combined sarcopenia and MetS to generate four groups: MetS-related sarcopenia group (MSS), sarcopenia group (S), MetS group (MS), and normal group (N).


RESULTS
A total of 749 patients with resectable GC were included in this study. Preoperative MetS was associated with sarcopenia (p < 0.001). Multivariate logistic regression presented that MetS-related sarcopenia (OR = 2.445; p = 0.010) and sarcopenia alone (OR = 2.117; p = 0.001) were independent predictors of grade Ⅱ and above complications, while MetS alone was not (p = 0.342). Cox regression analysis revealed that MetS-related sarcopenia led to the worst prognosis in the four groups (MSS vs MS: HR = 3.555, p < 0.001; MSS vs N: HR = 2.020, p = 0.003; MSS vs S: HR = 1.763, p = 0.021). However, the MetS group had better prognosis than the normal group (MS vs N: HR = 0.568, p = 0.048).


CONCLUSION
Preoperative MetS was associated with sarcopenia among GC patients. MetS-related sarcopenia resulted in a significantly worse prognosis. The long-term prognoses of patients with sarcopenia were impaired by preoperative MetS, while patients without sarcopenia benefited. Thus, patients with both sarcopenia and MetS require more medical interventions.
['Xu|Li-Bin|LB|', 'Zhang|Hui-Hui|HH|', 'Shi|Ming-Ming|MM|', 'Huang|Ze-Xin|ZX|', 'Zhang|Wei-Teng|WT|', 'Chen|Xiao-Dong|XD|', 'Cai|Yi-Qi|YQ|', 'Zhu|Guan-Bao|GB|', 'Shen|Xian|X|', 'Chen|Wen-Jing|WJ|']
D000230:Adenocarcinoma D000367:Age Factors D000368:Aged D016022:Case-Control Studies D002681:China D015897:Comorbidity D005260:Female D005743:Gastrectomy D006801:Humans D008297:Male D024821:Metabolic Syndrome D008875:Middle Aged D015999:Multivariate Analysis D060787:Neoplasm Grading D009367:Neoplasm Staging D011183:Postoperative Complications D011379:Prognosis D016016:Proportional Hazards Models D011446:Prospective Studies D055948:Sarcopenia D013274:Stomach Neoplasms
Sarcopenia Prognosis Gastric cancer Metabolic syndrome