Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients

Abstract Background Preoperative sarcopenia is an important risk factor for postoperative complications in patients with gastric cancer. However, the relationship between muscle quality and postoperative complications in patients with gastric cancer is inadequately studied. Therefore, we investigate...

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Main Authors: Ryota Matsui, Noriyuki Inaki, Toshikatsu Tsuji
Format: Article
Language:English
Published: Wiley 2021-07-01
Series:Annals of Gastroenterological Surgery
Subjects:
Online Access:https://doi.org/10.1002/ags3.12452
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author Ryota Matsui
Noriyuki Inaki
Toshikatsu Tsuji
author_facet Ryota Matsui
Noriyuki Inaki
Toshikatsu Tsuji
author_sort Ryota Matsui
collection DOAJ
description Abstract Background Preoperative sarcopenia is an important risk factor for postoperative complications in patients with gastric cancer. However, the relationship between muscle quality and postoperative complications in patients with gastric cancer is inadequately studied. Therefore, we investigated the impact of preoperative muscle quality on severe postoperative complications after radical gastrectomy. Methods A total of 840 patients who underwent radical gastrectomy for p‐stages I–III primary gastric cancer between April 2008 and June 2018 with preoperative computed tomography (CT) scans and body composition analysis were included. We measured intramuscular adipose tissue content (IMAC) as an indicator of muscle quality. A higher IMAC signified a poorer quality. All statistical analyses were performed with EZR, and a P‐value < 0.05 was considered statistically significant. Results The low‐IMAC and high‐IMAC groups had 422 (50.2%) and 418 (49.8%) patients, respectively. The latter were older (P < 0.001), had higher body mass index (BMI) (P < 0.001), and higher rates of chronic kidney disease (CKD) (P = 0.002) and diabetes (P < 0.001). They had lower skeletal muscle indexes (SMI) (P = 0.011) and higher visceral fat areas (VFA) (P < 0.001). They also experienced more intraoperative blood loss (P < 0.001) and greater complications (P = 0.016). Multivariate analysis showed that high‐IMAC was an independent risk factor for severe complications (odds ratio: 2.260, 95% confidence interval: 1.220‐4.190, P = 0.010). Conclusions Poor preoperative muscle quality is an independent risk factor for severe postoperative complications after radical gastrectomy in patients with gastric cancer.
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spelling doaj.art-32673c90c98d49a2afc07a951ef6f0942023-03-15T10:05:47ZengWileyAnnals of Gastroenterological Surgery2475-03282021-07-015451051810.1002/ags3.12452Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patientsRyota Matsui0Noriyuki Inaki1Toshikatsu Tsuji2Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Kanazawa JapanDepartment of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Kanazawa JapanDepartment of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Kanazawa JapanAbstract Background Preoperative sarcopenia is an important risk factor for postoperative complications in patients with gastric cancer. However, the relationship between muscle quality and postoperative complications in patients with gastric cancer is inadequately studied. Therefore, we investigated the impact of preoperative muscle quality on severe postoperative complications after radical gastrectomy. Methods A total of 840 patients who underwent radical gastrectomy for p‐stages I–III primary gastric cancer between April 2008 and June 2018 with preoperative computed tomography (CT) scans and body composition analysis were included. We measured intramuscular adipose tissue content (IMAC) as an indicator of muscle quality. A higher IMAC signified a poorer quality. All statistical analyses were performed with EZR, and a P‐value < 0.05 was considered statistically significant. Results The low‐IMAC and high‐IMAC groups had 422 (50.2%) and 418 (49.8%) patients, respectively. The latter were older (P < 0.001), had higher body mass index (BMI) (P < 0.001), and higher rates of chronic kidney disease (CKD) (P = 0.002) and diabetes (P < 0.001). They had lower skeletal muscle indexes (SMI) (P = 0.011) and higher visceral fat areas (VFA) (P < 0.001). They also experienced more intraoperative blood loss (P < 0.001) and greater complications (P = 0.016). Multivariate analysis showed that high‐IMAC was an independent risk factor for severe complications (odds ratio: 2.260, 95% confidence interval: 1.220‐4.190, P = 0.010). Conclusions Poor preoperative muscle quality is an independent risk factor for severe postoperative complications after radical gastrectomy in patients with gastric cancer.https://doi.org/10.1002/ags3.12452gastric cancerintramuscular adipose tissue contentmuscle qualitypostoperative severe complication
spellingShingle Ryota Matsui
Noriyuki Inaki
Toshikatsu Tsuji
Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
Annals of Gastroenterological Surgery
gastric cancer
intramuscular adipose tissue content
muscle quality
postoperative severe complication
title Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
title_full Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
title_fullStr Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
title_full_unstemmed Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
title_short Impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
title_sort impact of preoperative muscle quality on postoperative severe complications after radical gastrectomy for gastric cancer patients
topic gastric cancer
intramuscular adipose tissue content
muscle quality
postoperative severe complication
url https://doi.org/10.1002/ags3.12452
work_keys_str_mv AT ryotamatsui impactofpreoperativemusclequalityonpostoperativeseverecomplicationsafterradicalgastrectomyforgastriccancerpatients
AT noriyukiinaki impactofpreoperativemusclequalityonpostoperativeseverecomplicationsafterradicalgastrectomyforgastriccancerpatients
AT toshikatsutsuji impactofpreoperativemusclequalityonpostoperativeseverecomplicationsafterradicalgastrectomyforgastriccancerpatients