Postoperative skeletal muscle loss as a prognostic indicator of clinical outcomes in patients with gastric cancer: a systematic review and meta-analysis.

Abstract

Objectives: Decrease in skeletal muscle mass is frequently observed during the Perioperative period in gastric cancer (GC) patients and is strongly associated with postoperative complications and poor long-term survival outcomes. Relevant research indicates that a certain proportion of gastric cancer patients suffer from skeletal muscle mass loss after surgery. Therefore, we carried out a systematic review and meta-analysis to assess postoperative skeletal muscle loss as a prognostic marker for clinical outcomes in gastric cancer patients.

Methods: Using PubMed, Web of Science, and Embase, we systematically screened and retrieved relevant studies according to strictly established inclusion and exclusion criteria. We further analyzed the effect of postoperative skeletal muscle loss on long-term survival metrics (including Overall survival(OS),Recurrence-free survival(RFS),Disease-free survival(DFS),Disease-specific survival(DSS)) in gastric cancer patients.

Results: From 10 studies and 11 related publications, more than 3764 GC patients were identified. Severe postoperative skeletal muscle loss occurred in 25.7% of GC patients and was significantly correlated with poorer OS (HR=2.27, 95%CI, 1.58-3.25, p < 0.00001), RFS (HR=2.96, 95% CI, 1.47-5.97, p=0.002), DFS (HR=2.41, 95% CI, 1.17-4.97, p=0.02), and DSS (HR=4.12, 95% CI, 2.44-6.94, p < 0.00001).When postoperative skeletal muscle loss advanced to sarcopenia, patients had worse OS as well (HR=2.22, 95%CI, 1.49-3.30, p < 0.0001).

Conclusions: Patients who undergo radical surgery for gastric cancer often experience skeletal muscle mass loss, and significant skeletal muscle mass loss is linked to poorer survival outcomes. Identifying patients with significant skeletal muscle mass loss during follow-up and promptly providing tailored interventions like nutritional and exercise support is essential.