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A Novel Prognostic Scoring System Based on Preoperative Sarcopenia Predicts the Long-Term Outcome for Patients After R0 Resection for Gastric Cancer: Experiences of a High-Volume Center

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The relationship between sarcopenia and prognosis of gastric cancer (GC) is unclear. This study aimed to develop a prognostic scoring system combining sarcopenia with preoperative clinical parameters for patients with GC to predict 3-year overall survival (OS) and 3-year recurrence-free survival (RFS).

Methods

In this study, 924 patients with GC who underwent radical gastrectomy were retrospectively analyzed. The data were divided into a training set and a validation set. Sarcopenia was diagnosed by the cutoff value of the skeletal muscle index (SMI) obtained by X-tile software. The study used COX regression to identify preoperative risk factors associated with 3-year OS and RFS.

Results

In the training set, 103 patients (14.8%) were sarcopenic based on the cutoff value of the SMI (32.5 cm2/m2 for men and 28.6 cm2/m2 for women). Multivariate analysis showed the following preoperative risk factors for the training set: sarcopenia and preoperative T (cT) and N (cN) stages. A prognostic scoring system was developed based on these findings. The 3-year OS rates were 89% for the low-risk patients, 77.9% for the intermediate-risk patients, and 54.8% for the high-risk patients (P < 0.001), and the 3-year RFS rates were respectively 86.9, 75.3 and 49.3% (P < 0.001). The area under the receiver operating characteristic curves were 0.708 for the 3-year OS rates and 0.713 for the 3-year RFS rates. The observed and predicted incidence rates for 3-year OS and RFS in the validation set did not differ significantly.

Conclusions

The prognostic scoring system combining sarcopenia with the cT and cN system can accurately predict 3-year OS and RFS rates after radical gastrectomy for GC.

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Acknowledgement

This work was supported by the National Key Clinical Specialty Discipline Construction Program of China (No. [2012] 649) and the Key Projects of Science and Technology Plan of Fujian Province (no. 2014Y0025).

Disclosure

There are no conflicts of interest.

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Author notes

  1. Z.F.Z and J.L contributed equally to this work.

Authors and Affiliations

  1. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China

    Zhi-Fang Zheng MD, Jun Lu MD, Chao-Hui Zheng MD, ** Li MD, Jian-Wei **e MD, Jia-Bin Wang MD, Jian-**an Lin MD, Qi-Yue Chen MD, Mi Lin MD & Chang-Ming Huang MD

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  1. Zhi-Fang Zheng MD
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Correspondence to Chang-Ming Huang MD.

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Zheng, ZF., Lu, J., Zheng, CH. et al. A Novel Prognostic Scoring System Based on Preoperative Sarcopenia Predicts the Long-Term Outcome for Patients After R0 Resection for Gastric Cancer: Experiences of a High-Volume Center. Ann Surg Oncol 24, 1795–1803 (2017). https://doi.org/10.1245/s10434-017-5813-7

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  • DOI: https://doi.org/10.1245/s10434-017-5813-7

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