# Effect of Preoperative Sarcopenic Obesity on Outcomes in Patients with Gastric Cancer After Surgery

## TL;DR

This study shows that sarcopenic obesity, a condition with low muscle and high fat, is linked to worse survival in gastric cancer patients after surgery.

## Contribution

The study identifies sarcopenic obesity as an independent risk factor for poor outcomes in gastric cancer surgery.

## Key findings

- Patients with sarcopenic obesity had significantly worse overall survival compared to non-sarcopenic non-obese patients.
- Sarcopenic obesity was an independent risk factor for both overall and relapse-free survival after gastrectomy.
- The study used computed tomography to classify patients based on muscle and fat composition.

## Abstract

Sarcopenic obesity (SO) refers to the coexistence of low muscle mass and excess visceral fat. However, its prognostic impact in patients undergoing gastrectomy for gastric cancer remains unclear. In this study, preoperative body composition was assessed using computed tomography, and patients were classified into four groups based on skeletal muscle mass and visceral fat. Patients with SO showed significantly worse overall survival and relapse-free survival than those in other groups, even after adjustment for clinicopathological factors.

Background/Objectives: Preoperative body composition has been implicated as a factor affecting clinical outcomes in several types of cancer. However, there is limited evidence regarding whether preoperative body composition can predict the prognosis following gastrectomy for gastric cancer (GC). We aimed to investigate the role of preoperative body composition as a prognostic factor for overall survival (OS) and relapse-free survival (RFS) after gastrectomy for GC. Methods: This prospective study included 540 patients who underwent gastrectomy for GC at the Kanagawa Cancer Center, Japan, between December 2013 and November 2017. Preoperative body composition was assessed using the skeletal muscle index and visceral adipose tissue area derived from computed tomography scans. Patients were classified into four groups: non-sarcopenic non-obesity (NN), sarcopenic non-obesity (SN), non-sarcopenic obesity (NO), and sarcopenic obesity (SO). Results: A total of 448 patients (NN, 184; SN, 52; NO, 186; SO, 26) were included in the final analysis. In terms of OS, the SO group showed significantly worse survival than the NN group (72.1% vs. 87.6%, p = 0.01). Similarly, regarding RFS, the SO group had significantly worse outcomes than the NN group (68.4% vs. 86.2%, p = 0.007). Multivariate analysis identified SO as an independent risk factor for both OS (hazard ratio [HR], 3.18; 95% confidence interval [CI], 1.33–7.64; p = 0.01) and RFS (HR, 3.08; 95% CI, 1.36–6.95; p = 0.01). Conclusions: Preoperative SO was associated with poorer outcomes in patients undergoing gastrectomy for GC.