Cachexia and Sarcopenia as Predictive Factors in Patients With Gastric Cancer: Observational Study

Introduction. Gastric cancer commonly develops in elderly comorbid patients with nutritional impairments, with all those factors leading to the development of cachexia and/or sarcopenia.

The purpose of the study. To evaluate the prevalence of cachexia and sarcopenia in patients with gastric cancer and their correlation with complications of the treatment.

Materials and methods of research. We conducted a retro-prospective study including 225 patients: mean age was 66,3±10,5 years. Group 1 included 116 patients who got chemotherapy, Group 2 included 109 patients undergoing gastrectomy. Sarcopenia was defined according to pre-specified cut-offs based on semi-automated CT scan calculation of skeletal muscle at the L3 level. CT scans were obtained not more than 30 days before the beginning of the treatment.

Results. Cachexia was encountered in 75,9 % of patients. Sarcopenia according to Prado cut-offs was found in 76,8 % male and 56,3 % female, according to Martin cut-offs in 60,8 % male and 68,9 % female and according to EWGSOP2 criteria in 30,4 % male and 28,7 % female patients. Sarcopenic obesity was diagnosed in 6,2 % patients. We found a positive correlation between the presence of sarcopenia and asthenia (р=0,003) as well as nausea and vomiting (р=0,027) after the 1st line of chemotherapy in Group 1. Also a correlation between the presence of sarcopenia (Prado cut-offs) and post-operative mortality was found (р=0,024). Sarcopenic obesity increased the rate of severe complications (p=0,033) as well as mortality (p=0,005) in Group 2.

Conclusion. Cachexia and sarcopenia develop in more than a half of gastric cancer patients before the beginning of the treatment. Those factors increase both the rate of asthenia during chemotherapy and severe complications after surgery.

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