Baseline Sarcopenia and Skeletal Muscle Loss During Chemotherapy Affect Survival Outcomes in Metastatic Gastric Cancer

Abstract

Aim: To determine the association between sarcopenia and prognosis in patients with metastatic gastric cancer (mGC) receiving chemotherapy.

Patients and methods: Our study retrospectively evaluated 231 consecutive Japanese patients with mGC who commenced first-line chemotherapy at our Institution between January 2013 and December 2015. Muscle loss during chemotherapy was defined as a ≥10% reduction in the skeletal muscle index and was evaluated for its association with time to treatment failure (TTF) and overall survival (OS).

Results: Of 118 patients, 89% had baseline sarcopenia and 31% developed muscle loss. Muscle loss was significantly associated with shorter TTF and OS and was an independent prognostic factor for both these parameters; poor performance status and poorer differentiation on histology were also significant predictors of shorter OS. However, muscle loss was not significantly associated with increased grade 3 or higher toxicities.

Conclusion: Muscle loss during chemotherapy negatively affected survival among patients with mGC.

Keywords: Chemotherapy; gastric cancer; prognostic factor; sarcopenia; skeletal muscle loss.