The impact of sarcopenia on short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer
Background Sarcopenia prevalence has increased in proportion to the aging population in Japan. We aimed to investigate the association between sarcopenia and clinical outcomes and the prognostic factors of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Methods This retrospective study involved patients aged ≥ 65 years who had undergone gastric ESD for EGC at our institution between January 2009 and December 2019. Patients were divided into two groups, namely, a sarcopenia group (109 patients) and a non-sarcopenia group (658 patients), based on the skeletal muscle index and intramuscular adipose tissue content (IMAC). Clinicopathological features, ESD-related adverse events, and outcomes were then compared. Results In the sarcopenia group, the mean age was higher, whereas performance and nutritional statuses were lower. There were no between-group differences in terms of treatment outcomes. Multivariate analyses (odds ratio [95% confidence interval (CI)]) indicated that a geriatric nutritional risk index score (GNRI) < 92 (2.12 [1.09–4.11], p = 0.03), anticoagulant therapy (1.76 [1.13–2.76], p = 0.01), tumor size ≥ 30 mm (2.09 [1.23–3.55], p = 0.01), and sarcopenia (1.90 [1.05–3.45], p = 0.03) were significantly associated with ESD-related adverse events. High Charlson comorbidity index, low prognostic nutritional index, low GNRI, and high IMAC were significantly associated with poor overall survival (OS). OS was significantly shorter in the sarcopenia group even after matching. Conclusions Patients with sarcopenia had significantly more adverse events and shorter OS; therefore, evaluation of a patient’s general condition, including sarcopenia, before ESD is important..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:57 |
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| Enthalten in: |
Journal of gastroenterology - 57(2022), 12 vom: 21. Sept., Seite 952-961 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hisada, Hiroyuki [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Elderly |
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| Anmerkungen: |
© Japanese Society of Gastroenterology 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s00535-022-01923-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Background Sarcopenia prevalence has increased in proportion to the aging population in Japan. We aimed to investigate the association between sarcopenia and clinical outcomes and the prognostic factors of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Methods This retrospective study involved patients aged ≥ 65 years who had undergone gastric ESD for EGC at our institution between January 2009 and December 2019. Patients were divided into two groups, namely, a sarcopenia group (109 patients) and a non-sarcopenia group (658 patients), based on the skeletal muscle index and intramuscular adipose tissue content (IMAC). Clinicopathological features, ESD-related adverse events, and outcomes were then compared. Results In the sarcopenia group, the mean age was higher, whereas performance and nutritional statuses were lower. There were no between-group differences in terms of treatment outcomes. Multivariate analyses (odds ratio [95% confidence interval (CI)]) indicated that a geriatric nutritional risk index score (GNRI) < 92 (2.12 [1.09–4.11], p = 0.03), anticoagulant therapy (1.76 [1.13–2.76], p = 0.01), tumor size ≥ 30 mm (2.09 [1.23–3.55], p = 0.01), and sarcopenia (1.90 [1.05–3.45], p = 0.03) were significantly associated with ESD-related adverse events. High Charlson comorbidity index, low prognostic nutritional index, low GNRI, and high IMAC were significantly associated with poor overall survival (OS). OS was significantly shorter in the sarcopenia group even after matching. Conclusions Patients with sarcopenia had significantly more adverse events and shorter OS; therefore, evaluation of a patient’s general condition, including sarcopenia, before ESD is important. | ||
| 650 | 4 | |a Gastric cancer | |
| 650 | 4 | |a Sarcopenia | |
| 650 | 4 | |a Endoscopic submucosal dissection | |
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