Prognostic significance of anthropometric measurements in gastric cancer: a multicenter cohort study.

PURPOSE: Anthropometric measurements are practical tools for nutritional assessment, yet their prognostic value in gastric cancer remains understudied. This multicenter cohort study aimed to evaluate the association of multidimensional anthropometric parameters with overall survival (OS), metastasis, malnutrition, and cachexia in gastric cancer patients.

METHODS

This multicenter cohort study enrolled 2,343 patients with gastric cancer. Baseline anthropometric measurements, including body mass index (BMI), mid-arm circumference (MAC), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), mid-arm muscle area (MAMA), calf circumference (CC), and handgrip strength (HGS), were collected. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox regression analysis. Receiver operating characteristic (ROC) curves and C-index were used to compare the prognostic accuracy of anthropometric measurements. Logistic regression analysis assessed associations with metastasis, severe malnutrition, and cachexia.

RESULTS

Cox regression analysis revealed that higher anthropometric measurements were significantly associated with improved OS. Specifically, higher CC (HR = 0.658, 95% CI 0.581-0.746, p < 0.001) demonstrated the strongest protective effects against survival. ROC curves showed that CC had the best predictive performance in both males (AUC = 0.712) and females (AUC = 0.689), followed by BMI (males AUC = 0.698, females AUC = 0.673). C-index comparison further validated the advantage of CC, with slightly higher predictive accuracy in males (C-index = 0.574) and females (C-index = 0.576) compared to BMI (males 0.571, females 0.545). Logistic regression analysis indicated that higher anthropometric measurements were associated with lower odds of metastasis, severe malnutrition, and cachexia. Notably, MAC performed best in assessing malnutrition, followed by CC.

CONCLUSION

Anthropometric measurements, particularly CC, are robust predictors of OS, metastasis, malnutrition, and cachexia in gastric cancer patients.