Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4668
Peer-review started: February 6, 2021
First decision: March 16, 2021
Revised: March 23, 2021
Accepted: April 20, 2021
Article in press: April 20, 2021
Published online: June 26, 2021
Sarcopenia is a nutrition-related disease and has a profound effect on the long-term overall survival (OS) of patients with gastric cancer. Previous studies reported widely differing sarcopenia prevalence due to different criteria. AWGS2019 and EWGSOP2 are two latest and extensively adopted criteria.
To compare the effects of these two criteria on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.
To determine which method for diagnosing sarcopenia is more appropriate for Chinese gastric cancer patient after radical gastrectomy.
An observational study was conducted from July 2014 to January 2017. Multivariate cox regression analysis was performed to determine the association of sarcopenia according to these two criteria separately with the long-term OS of these patients. The predictive performance of the models with AWGS2019 and EWGSOP2 was evaluated using the concordance index and area under the time-dependent receiver operating characteristic curve. The Akaike information criterion was used to compare model fits.
Sarcopenia was an independent risk factor for the long-term OS no matter based on AWGS2019 or EWGSOP2, but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio than EWGSOP2-sarcopenia. Meanwhile, the model with AWGS2019-sarcopenia had better predictive power and model fits than the model with EWGSOP2-sarcopenia.
Sarcopenia based on both criteria is an independent risk factor for the long-term OS in Chinese patients undergoing radical gastrectomy for gastric cancer. The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia. AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.
Surgeons should be aware of the importance of sarcopenia and pay close attention to the nutrition of these patients. Corresponding clinical interventions to ameliorate the effect of sarcopenia on the long-term OS need further evaluation in prospective clinical trials.