Laparoscopic radical gastrectomy is a protective factor for clinical outcomes in gastric cancer patients with sarcopenia.

PURPOSE: Sarcopenia is common among individuals afflicted with gastric cancer (GC), and can culminate in unfavorable prognoses. Nevertheless, the efficacy of surgical interventions in GC patients with sarcopenia remains ambiguous. This study compared the prognostic value of laparoscopic and open radical gastrectomy in GC patients with sarcopenia.

METHODS

GC patients with preoperative sarcopenia who underwent radical gastrectomy were enrolled in our study. The patients' outcomes were stratified based on the surgical approach. After correcting for bias in clinical characteristics using propensity score matching, the prognoses of two groups were compared, and independent risk factors for postoperative complications, overall survival (OS) and disease-free survival (DFS) were analyzed.

RESULTS

Our study included a total of 136 individuals after propensity score matching, with a postoperative complication rate of 39.0 %. Compared with patients who underwent open gastrectomy, those who opted for laparoscopic gastrectomy exhibited a lower incidence of surgical complications (13.2 % vs 35.3 %, P = 0.003) and better prognoses. By conducting a comprehensive analysis of statistical results, it had been determined that laparoscopic surgery was identified as an independent protective factor for surgical complications (OR = 0.244(0.098-0.607); P = 0.004), OS (HR = 0.522(0.0.297-0.919); P = 0.024), and DFS (HR = 0.459(0.234-0.902); P = 0.024).

CONCLUSIONS

Laparoscopic gastrectomy achieves a better long-term prognosis and significantly reduces the incidence of postoperative surgical complications for GC patients with sarcopenia.