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SYSTEMATIC REVIEW article

Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1516873

The Impact of Preoperative Skeletal Muscle Mass Index-Defined Sarcopenia on Postoperative Complications and Survival in Gastric Cancer: An Updated Meta-Analysis

Provisionally accepted
Chengcong Liu Chengcong Liu Yueping Li Yueping Li Yongjing Xu Yongjing Xu Hong Hou Hong Hou *
  • Qingdao Central Hospital, Qingdao, China

The final, formatted version of the article will be published soon.

    The impact of preoperative sarcopenia on postoperative outcomes in gastric cancer remains debated. This study aims to perform an in-depth meta-analysis and comprehensive review of the relationship between preoperative sarcopenia, as assessed by the Skeletal Muscle Mass Index (SMI), and postoperative complications and survival metrics in gastric cancer patients, to offer new insights into this issue. Methods: We conducted a systematic search of primary studies in databases such as Embase, PubMed, and Web of Science, up to July 2024. Our analysis focused on comparing postoperative readmission and mortality rates, overall and severe complication rates, incidence of specific complications, as well as overall survival (OS) and disease-free survival (DFS) between groups with and without preoperative sarcopenia. Results: Our review included 42 studies with a total of 11,981 patients. Findings revealed that patients with sarcopenia had significantly higher rates of overall postoperative complications, severe complications, mortality, and readmissions compared to those without sarcopenia (all P<0.001). A detailed examination showed that sarcopenic patients had notably higher incidences of pulmonary complications, bowel obstruction, and pancreatic fistulas. Additionally, the OS (P < 0.001) and DFS (P = 0.003) rates were considerably lower in the sarcopenia group. Conclusions: Preoperative sarcopenia is associated with an increased risk of postoperative complications and poorer survival outcomes in gastric cancer patients. Given these associations, it is recommended to incorporate routine screening for sarcopenia using SMI before surgery, where feasible, to enhance patient risk assessment and customize treatment approaches.

    Keywords: gastric cancer, complications, Sarcopenia, overall survival, Disease-Free Survival

    Received: 25 Oct 2024; Accepted: 12 Dec 2024.

    Copyright: © 2024 Liu, Li, Xu and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hong Hou, Qingdao Central Hospital, Qingdao, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.