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Erschienen in: Surgery Today 7/2021

13.03.2021 | Original Article

The impact of the preoperative hand grip strength on the long-term outcomes after gastrectomy for advanced gastric cancer

verfasst von: Ryota Matsui, Noriyuki Inaki, Toshikatsu Tsuji

Erschienen in: Surgery Today | Ausgabe 7/2021

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Abstract

Purpose

The correlation of the hand grip strength (HGS) and long-term outcomes after gastrectomy for gastric cancer patients is unknown. This study reveals the impact of the pre-operative HGS on the post-operative survival in gastric cancer patients.

Methods

This study is a retrospective cohort of consecutive patients who underwent gastrectomy for primary p-T2 (MP) or more advanced gastric cancer from September 2014 to April 2018 with records of pre-operative HGS. The high and low HGS groups were compared by Kaplan–Meier survival analyses for the overall survival (OS), cancer-specific survival (CSS), other-cause survival (OCS), and disease-free survival (DFS).

Results

Of the 96 patients, 35 (36.5%) were in the low HGS group, and 61 (63.5%) were in the high HGS group. The OS was significantly worse in the low HGS group than in the high HGS group (P = 0.013). There was no marked difference in the CSS (P = 0.214) or DFS (P = 0.675) between the groups, but the OCS was worse in the low HGS group than in the high HGS group (P = 0.029). Multivariate analyses of the prognostic factors concluded that a low HGS (P = 0.031) and open surgery (P = 0.011) were significant independent factors.

Conclusions

A low pre-operative HGS is an independent predictor of a poor prognosis after gastrectomy for patients with advanced gastric cancer and may increase the risk of other causes of death.
Literatur
1.
Zurück zum Zitat Kawamura T, Makuuchi R, Tokunaga M, Tanizawa Y, Bando E, Yasui H, et al. Long-term outcomes of gastric cancer patients with preoperative sarcopenia. Ann Surg Oncol. 2018;25(6):1625–32.CrossRef Kawamura T, Makuuchi R, Tokunaga M, Tanizawa Y, Bando E, Yasui H, et al. Long-term outcomes of gastric cancer patients with preoperative sarcopenia. Ann Surg Oncol. 2018;25(6):1625–32.CrossRef
2.
Zurück zum Zitat Zhuang CL, Huang DD, Pang WY, Zhou CJ, Wang SL, Lou N, et al. Sarcopenia is an independent predictor of severe postoperative complications and long-term survival after radical gastrectomy for gastric cancer: analysis from a large-scale cohort. Medicine (Baltimore). 2016;95(13):e3164.CrossRef Zhuang CL, Huang DD, Pang WY, Zhou CJ, Wang SL, Lou N, et al. Sarcopenia is an independent predictor of severe postoperative complications and long-term survival after radical gastrectomy for gastric cancer: analysis from a large-scale cohort. Medicine (Baltimore). 2016;95(13):e3164.CrossRef
3.
Zurück zum Zitat Zheng ZF, Lu J, Zheng CH, Li P, Xie JW, Wang JB, et al. A novel prognostic scoring system based on preoperative sarcopenia predicts the long-term outcome for patients After R0 resection for gastric cancer: experiences of a high-volume center. Ann Surg Oncol. 2017;24(7):1795–803.CrossRef Zheng ZF, Lu J, Zheng CH, Li P, Xie JW, Wang JB, et al. A novel prognostic scoring system based on preoperative sarcopenia predicts the long-term outcome for patients After R0 resection for gastric cancer: experiences of a high-volume center. Ann Surg Oncol. 2017;24(7):1795–803.CrossRef
4.
Zurück zum Zitat Sierzega M, Chrzan R, Wiktorowicz M, Kolodziejczyk P, Richter P. Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach. J Surg Oncol. 2019;120(3):473–82.CrossRef Sierzega M, Chrzan R, Wiktorowicz M, Kolodziejczyk P, Richter P. Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach. J Surg Oncol. 2019;120(3):473–82.CrossRef
5.
Zurück zum Zitat Lu J, Zheng ZF, Li P, Xie JW, Wang JB, Lin JX, et al. A novel preoperative skeletal muscle measure as a predictor of postoperative complications, long-term survival and tumor recurrence for patients with gastric cancer after radical gastrectomy. Ann Surg Oncol. 2018;25(2):439–48.CrossRef Lu J, Zheng ZF, Li P, Xie JW, Wang JB, Lin JX, et al. A novel preoperative skeletal muscle measure as a predictor of postoperative complications, long-term survival and tumor recurrence for patients with gastric cancer after radical gastrectomy. Ann Surg Oncol. 2018;25(2):439–48.CrossRef
6.
Zurück zum Zitat Yang Z, Zhou X, Ma B, Xing Y, Jiang X, Wang Z. Predictive value of preoperative sarcopenia in patients with gastric cancer: a meta-analysis and systematic review. J Gastrointest Surg. 2018;22(11):1890–902.CrossRef Yang Z, Zhou X, Ma B, Xing Y, Jiang X, Wang Z. Predictive value of preoperative sarcopenia in patients with gastric cancer: a meta-analysis and systematic review. J Gastrointest Surg. 2018;22(11):1890–902.CrossRef
7.
Zurück zum Zitat Kamarajah SK, Bundred J, Tan BHL. Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta-analysis. Gastric Cancer. 2019;22(1):10–22.CrossRef Kamarajah SK, Bundred J, Tan BHL. Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta-analysis. Gastric Cancer. 2019;22(1):10–22.CrossRef
8.
Zurück zum Zitat Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–23.CrossRef Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–23.CrossRef
9.
Zurück zum Zitat Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.CrossRef Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.CrossRef
10.
Zurück zum Zitat Sato T, Aoyama T, Hayashi T, Segami K, Kawabe T, Fujikawa H, et al. Impact of preoperative hand grip strength on morbidity following gastric cancer surgery. Gastric Cancer. 2016;19(3):1008–15.CrossRef Sato T, Aoyama T, Hayashi T, Segami K, Kawabe T, Fujikawa H, et al. Impact of preoperative hand grip strength on morbidity following gastric cancer surgery. Gastric Cancer. 2016;19(3):1008–15.CrossRef
11.
Zurück zum Zitat Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab. 2008;33(5):997–1006.CrossRef Mourtzakis M, Prado CM, Lieffers JR, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Appl Physiol Nutr Metab. 2008;33(5):997–1006.CrossRef
12.
Zurück zum Zitat Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48(3):452–8.CrossRef Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48(3):452–8.CrossRef
13.
Zurück zum Zitat Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629–35.CrossRef Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629–35.CrossRef
14.
Zurück zum Zitat Martin L, Birdsell L, Macdonald N, Reiman T, Clandinin MT, McCargar LJ, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 2013;31(12):1539–47.CrossRef Martin L, Birdsell L, Macdonald N, Reiman T, Clandinin MT, McCargar LJ, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 2013;31(12):1539–47.CrossRef
15.
Zurück zum Zitat Sakurai K, Kubo N, Tamura T, Toyokawa T, Amano R, Tanaka H, et al. Adverse effects of low preoperative skeletal muscle mass in patients undergoing gastrectomy for gastric cancer. Ann Surg Oncol. 2017;24(9):2712–9.CrossRef Sakurai K, Kubo N, Tamura T, Toyokawa T, Amano R, Tanaka H, et al. Adverse effects of low preoperative skeletal muscle mass in patients undergoing gastrectomy for gastric cancer. Ann Surg Oncol. 2017;24(9):2712–9.CrossRef
16.
Zurück zum Zitat Iritani S, Imai K, Takai K, Hanai T, Ideta T, Miyazaki T, et al. Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol. 2015;50(3):323–32.CrossRef Iritani S, Imai K, Takai K, Hanai T, Ideta T, Miyazaki T, et al. Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol. 2015;50(3):323–32.CrossRef
17.
Zurück zum Zitat Nishigori T, Tsunoda S, Obama K, Hisamori S, Hashimoto K, Itatani Y, et al. Optimal cutoff values of skeletal muscle index to define sarcopenia for prediction of survival in patients with advanced gastric cancer. Ann Surg Oncol. 2018;25(12):3596–603.CrossRef Nishigori T, Tsunoda S, Obama K, Hisamori S, Hashimoto K, Itatani Y, et al. Optimal cutoff values of skeletal muscle index to define sarcopenia for prediction of survival in patients with advanced gastric cancer. Ann Surg Oncol. 2018;25(12):3596–603.CrossRef
18.
Zurück zum Zitat Sato S, Nagai E, Taki Y, Watanabe M, Watanabe Y, Nakano K, et al. Hand grip strength as a predictor of postoperative complications in esophageal cancer patients undergoing esophagectomy. Esophagus. 2018;15(1):10–8.CrossRef Sato S, Nagai E, Taki Y, Watanabe M, Watanabe Y, Nakano K, et al. Hand grip strength as a predictor of postoperative complications in esophageal cancer patients undergoing esophagectomy. Esophagus. 2018;15(1):10–8.CrossRef
19.
Zurück zum Zitat Ma BW, Chen XY, Fan SD, Zhang FM, Huang DD, Li B, et al. Impact of sarcopenia on clinical outcomes after radical gastrectomy for patients without nutritional risk. Nutrition. 2019;61:61–6.CrossRef Ma BW, Chen XY, Fan SD, Zhang FM, Huang DD, Li B, et al. Impact of sarcopenia on clinical outcomes after radical gastrectomy for patients without nutritional risk. Nutrition. 2019;61:61–6.CrossRef
20.
Zurück zum Zitat Jiang N, Deng JY, Ding XW, Zhang L, Liu HG, Liang YX, et al. Effect of complication grade on survival following curative gastrectomy for carcinoma. World J Gastroenterol. 2014;20(25):8244–52.CrossRef Jiang N, Deng JY, Ding XW, Zhang L, Liu HG, Liang YX, et al. Effect of complication grade on survival following curative gastrectomy for carcinoma. World J Gastroenterol. 2014;20(25):8244–52.CrossRef
21.
Zurück zum Zitat Wang S, Xu L, Wang Q, Li J, Bai B, Li Z, et al. Postoperative complications and prognosis after radical gastrectomy for gastric cancer: a systematic review and meta-analysis of observational studies. World J Surg Oncol. 2019;17(1):52.CrossRef Wang S, Xu L, Wang Q, Li J, Bai B, Li Z, et al. Postoperative complications and prognosis after radical gastrectomy for gastric cancer: a systematic review and meta-analysis of observational studies. World J Surg Oncol. 2019;17(1):52.CrossRef
22.
Zurück zum Zitat Chainani V, Shaharyar S, Dave K, Choksi V, Ravindranathan S, Hanno R, et al. Objective measures of the frailty syndrome (hand grip strength and gait speed) and cardiovascular mortality: a systematic review. Int J Cardiol. 2016;215:487–93.CrossRef Chainani V, Shaharyar S, Dave K, Choksi V, Ravindranathan S, Hanno R, et al. Objective measures of the frailty syndrome (hand grip strength and gait speed) and cardiovascular mortality: a systematic review. Int J Cardiol. 2016;215:487–93.CrossRef
23.
Zurück zum Zitat Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol. 2009;103(11):1616–21.CrossRef Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol. 2009;103(11):1616–21.CrossRef
24.
Zurück zum Zitat Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta-analysis. Geriatr Gerontol Int. 2016;16(1):5–20.CrossRef Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta-analysis. Geriatr Gerontol Int. 2016;16(1):5–20.CrossRef
25.
Zurück zum Zitat Hayashi T, Yoshikawa T, Aoyama T, Hasegawa S, Yamada T, Tsuchida K, et al. Impact of infectious complications on gastric cancer recurrence. Gastric Cancer. 2015;18(2):368–74.CrossRef Hayashi T, Yoshikawa T, Aoyama T, Hasegawa S, Yamada T, Tsuchida K, et al. Impact of infectious complications on gastric cancer recurrence. Gastric Cancer. 2015;18(2):368–74.CrossRef
26.
Zurück zum Zitat Tamura T, Sakurai K, Nambara M, Miki Y, Toyokawa T, Kubo N, et al. Adverse effects of preoperative sarcopenia on postoperative complications of patients with gastric cancer. Anticancer Res. 2019;39(2):987–92.CrossRef Tamura T, Sakurai K, Nambara M, Miki Y, Toyokawa T, Kubo N, et al. Adverse effects of preoperative sarcopenia on postoperative complications of patients with gastric cancer. Anticancer Res. 2019;39(2):987–92.CrossRef
27.
Zurück zum Zitat Fukuda Y, Yamamoto K, Hirao M, Nishikawa K, Nagatsuma Y, Nakayama T, et al. Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy. Gastric Cancer. 2016;19(3):986–93.CrossRef Fukuda Y, Yamamoto K, Hirao M, Nishikawa K, Nagatsuma Y, Nakayama T, et al. Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy. Gastric Cancer. 2016;19(3):986–93.CrossRef
28.
Zurück zum Zitat Shen Y, Hao Q, Zhou J, Dong B. The impact of frailty and sarcopenia on postoperative outcomes in older patients undergoing gastrectomy surgery: a systematic review and meta-analysis. BMC Geriatr. 2017;17(1):188.CrossRef Shen Y, Hao Q, Zhou J, Dong B. The impact of frailty and sarcopenia on postoperative outcomes in older patients undergoing gastrectomy surgery: a systematic review and meta-analysis. BMC Geriatr. 2017;17(1):188.CrossRef
29.
Zurück zum Zitat Fukumoto Y, Ikezoe T, Yamada Y, Tsukagoshi R, Nakamura M, Mori N, et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol. 2012;112(4):1519–25.CrossRef Fukumoto Y, Ikezoe T, Yamada Y, Tsukagoshi R, Nakamura M, Mori N, et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol. 2012;112(4):1519–25.CrossRef
30.
Zurück zum Zitat Waki Y, Irino T, Makuuchi R, Notsu A, Kamiya S, Tanizawa Y, et al. Impact of preoperative skeletal muscle quality measurement on long-term survival after curative gastrectomy for locally advanced gastric cancer. World J Surg. 2019;43(12):3083–93.CrossRef Waki Y, Irino T, Makuuchi R, Notsu A, Kamiya S, Tanizawa Y, et al. Impact of preoperative skeletal muscle quality measurement on long-term survival after curative gastrectomy for locally advanced gastric cancer. World J Surg. 2019;43(12):3083–93.CrossRef
Metadaten
Titel
The impact of the preoperative hand grip strength on the long-term outcomes after gastrectomy for advanced gastric cancer
verfasst von
Ryota Matsui
Noriyuki Inaki
Toshikatsu Tsuji
Publikationsdatum
13.03.2021
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 7/2021
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-021-02256-y

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