The effect of sarcopenia on early clinical results in patients undergoing surgical treatment for gastric cancer

Objective: In this study we investigated the effects of sarcopenia on early clinical results in patients undergoing surgical treatment for gastric cancer Material-Method: Sarcopenia; it is a clinical condition that is revealed by evaluating muscle mass, muscle strenght and physical performance together. The study was planned as a prospective observational study ( Clinicaltrials registration number NCT 03958032 ) and was carried out at Karadeniz Technical University Faculty of Medicine, Farabi Hospital. Patients who underwent gastrectomy for gastric cancer between December 2016 and March 2020 were included in the study. Patients with non-adenocarsinoma pathology, ASA score IV, neurological impairment, thoracotomy, non-resection, requiring emergency surgery, and other concurrent organ malignencies were excluded from the study. Musle mass, musle strengh and physical performance were evaluated for the diagnosis of sarcopenia, sarcopenia was diagnosed in the revised criteria of the European Elderly People's Sarcopenia Study Gruop. The primary endpoint of the study is the complication rate (Clavien-Dindo classification). The secondary endpoints of the study were determined as mortality rate, length of hospital stay, and 30-day re-admission rate. Findings: During the study period, 185 patients were operated for gastric adenocarcinoma, of which 146 patients were included in the analysis. Sarcopenia was detected in 31 (21.2%) of the included patients. Complications were observed in 17 (54.8%) of 31 patients with sarcopenia and 35 (30.4%) of 115 patients without sarcopenia. It was determined that splenectomy, operation time lasting more than 120 minutes, bleeding more than 100 cc and type of gastrectomy were risk factors for complications. In univariate analysis applied to parameters related to sarcopenia, it was found that insufficient muscle strength, presence of sarcopenia and the presence of severe sarcopenia were statistically significant in terms of complications. In the multivariate analysis applied to the parameters related to sarcopenia, it was found that sarcopenia alone was not an independent factor, only the presence of severe sarcopenia was an independent risk factor for complications. Conclusion: The presence of sarcopenia in patients scheduled for surgical treatment due to gastric cancer is not sufficient alone to predict complications. Since the presence of severe sarcopenia is determined as an independent risk factor for complications, muscle mass, muscle strength and physical performance should be evaluated together. Key words: Gastic Cancer, Sarcopenia, Surgical Treatment, Complicatio