The Relationship of Sarcopenia With Prognosis in Patients Diagnosed with Metastatıc Gastric Cancer Receiving Palliative Chemotherapy
Abstract
Background: This study aimed to evaluate sarcopenia on baseline and follow-up tomography images taken after the 6th course of treatment in metastatic gastric cancer patients receiving palliative chemotherapy and to determine its relationship with survival and chemotherapy-induced toxicity.
Methods: In this retrospective study, we analyzed age, sex, comorbidities, histopathological subtype, ECOG performance status, sarcopenia presence, metastasis number and site, and serum markers (albumin, LDH, CEA, CA19-9) in patients followed at the Medical Oncology Outpatient Clinic between 01.01.2016 and 01.08.2020. Skeletal Muscle Index (SMI) and Standardized Mean Difference (SMD) values were calculated at the L3 level on CT before and after chemotherapy. We examined the impact of sarcopenia on progression-free survival, overall survival, and chemotherapy toxicity.
Results: Forty patients were included. Sarcopenia was present in 10 patients (25%) at diagnosis. Mean pre-treatment SMI and SMD values were 58.8 cm²/m² and 55.9 HU, respectively. Patients with sarcopenia had worse ECOG scores (p=0.000) and a higher rate of metastasis in ≥3 sites (p=0.000). Post-treatment SMI and BMI were lower than pre-treatment values (p=0.000). Median overall survival was 20.1 months (16-30, 95% CI). There was no significant difference in survival between sarcopenic and non-sarcopenic patients (p=0.754). Multivariate analysis showed no significant association between sarcopenia and survival or chemotherapy-induced toxicity.
Conclusion: Sarcopenia had no significant effect on survival or chemotherapy-related toxicity. However, the increase in sarcopenia and decreased SMI post-treatment highlight chemotherapy’s negative impact on muscle mass.
Keywords
Metastatic gastric cancer, SMI, Sarcopenia, Chemotherapy
Ethical Statement
Prior to the study, local ethics committee approval was taken from the University of Health Sciences, Umraniye Training and Research Hospital (Protocol No:13.08.2020/304).
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