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Impact of metabolic syndrome on the short- and long-term outcomes for the elderly patients with gastric cancer after radical gastrectomy - 24/11/22

Doi : 10.1016/j.clinre.2022.102041 
He Wu a, , Hao-Jie Jiang c, , Su-Lin Wang c, Xi-Yi Chen c, Liang-Liang Ma c, Zhen Yu c, d, , Chong-Jun Zhou b,
a Department of Emergency Medicine, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China 
b Department of Anorectal Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China 
c Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China 
d Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China 

#Corresponding authors.

Highlights

MetS was defined based on visceral fat area (VFA) instead of BMI or waist circumference.
The cutoff values for VFA were 96.1 cm2 for men and 105.2 cm2 for women.
MetS was an independent risk factor for complications after radical gastrectomy.

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Abstract

Background

Metabolic syndrome (MetS) and gastric cancer are age-related diseases, and their incidence rates have risen in past decades. However, few studies have examined the relationship between MetS and the prognosis of elderly patients who underwent radical gastrectomy, and the conclusions remain controversial.

Methods

We conducted a prospective study of elderly patients who underwent radical gastrectomy for gastric cancer from August 2014 to February 2018. MetS was defined based on visceral fat area (VFA) instead of BMI or waist circumference. Receiver operating characteristic curve analysis was used to determine the cutoff values for VFA.

Results

A total of 585 patients were included in this study. The optimal cutoff values for VFA were 96.1 cm2 for men and 105.2 cm2 for women, and 212 patients were diagnosed with MetS. The patients with MetS suffered significantly more postoperative complications than those without MetS (37.3% versus 21.4%, P < 0.001). The multivariable logistic regression analysis demonstrated that MetS (OR 2.923, P < 0.001), BMI < 18.5 kg/m2 (OR 2.086, P = 0.045), cardiac tumor (OR 1.865, P = 0.013), and Nutritional Risk Screening 2002 scores ≥ 3 (OR 1.654, P = 0.015) were independent risk factors for postoperative complications. During a median follow-up period of 56.4 months, the MetS group and the non-MetS group had comparable overall survival and disease-specific survival.

Conclusions

MetS was an independent risk factor for complications of the elderly patients after radical gastrectomy, but had no influence on long-term survival.

Le texte complet de cet article est disponible en PDF.

Keywords : Metabolic syndrome, Elderly patients, Gastric cancer, Postoperative complication, Survival


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Vol 46 - N° 10

Article 102041- décembre 2022 Retour au numéro
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