Effects of Sarcopenia on Early Postoperative Outcomes in Patients Undergoing Surgical Treatment for Gastric Cancer

Study Overview
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Brief Summary
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We aimed to establish the effects of sarcopenia on postoperative complications among patients undergoing surgical treatment for gastric cancer

Detailed Description
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Among gastrointestinal disease, gastric cancer is a malignancy which is diagnosed predominantly in advanced stages, mostly accompanied with malnutrition when diagnosed, has aggressive behavior with poor oncological outcomes. The only option for curative treatment is surgical resection in this malignancy; however, the surgical procedure itself causes high morbidity and mortality rates. Therefore, physicians combine various treatment modalities and risk assessment to decrease complication and mortality rates. Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death. For the diagnosis of sarcopenia, using the presence of both low muscle mass and decreased muscle function (strength or performance) is recommended. Previous studies showed that colorectal or pancreatic cancer accompanied with sarcopenia has adverse effects on not only for short term and also for long term outcomes. The majority of studies regarding gastric cancer was published from Eastern countries owing to their high incidence. There are few studies from western countries which are mostly retrospective and does not meet the diagnostic criteria of sarcopenia. In the western population, there is no high-quality evidence so far regarding the impact of sarcopenia on early outcomes of gastric cancer surgical treatment.

Official Title
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Effects of Sarcopenia on Early Postoperative Outcomes in Patients Undergoing Surgical Treatment for Gastric Cancer

Conditions
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Gastric Cancer, Sarcopenia, Malnutrition; Cachexia, Complication

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing gastric surgery for gastric cancer Histologically proven gastric adenocarcinoma Patients over 18 years Patients who agreed to participate in the study Exclusion Criteria: patients treated by non-surgical treatment such as endoscopic treatment, palliative chemotherapy) patients received palliative surgery without gastric resection (bypass procedures) patients required thoracotomy/thoracoscopy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Participants with gastric cancer<br>All consecutive patients undergoing surgery due to gastric cancer will be included in this study. | Other: No intervention<br>* No intervention is planned for the participants for the treatment of gastric cancer. Treatment decision will be in line with clinical practice guidelines. Surgical team will be blind to the participant's sarcopenia status.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative complications | complications graded by Clavien-Dindo Complication Classification System | within 30 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of hospital stay | time interval from the date of operation to the date of discharge | up to 90 days | 
| Mortality | Dying after surgery | within 30 days after surgery | 
| Readmission rate | readmission to the hospital because of the adverse events after discharge | within 30 days after surgery | 
| Incidence of sarcopenia | Sarcopenia consensus defined by The European Working Group on Sarcopenia in Older People | one day before surgery | 
| Muscle mass volume | muscle mass volume of a cross-sectional computerized- tomography image of the L3, corrected for patient height resulting in L3 muscle index. | one day before surgery | 
| Psoas muscle mass volume | muscle mass volume of Psoas muscle with 3D reconstruction | one day before surgery | 
| Muscle strength | evaluated by handgrip strength test (with digital dynamometer) | one day before surgery | 
| Physical performance | evaluated by 4-meter gait speed test | one day before surgery | 
| Major complication | grade 3 or higher complications graded by Clavien-Dindo Complication Classification System | within 30 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sarcopenia, cancer, gastrointestinal