Clinical impact of CT-defined sarcopenia on long-term oncological outcomes in gastric cancer: validation of muscle mass cut-offs established according to EWGSOP recommendations.

Authors

Jasmin Hasanovic, Paul Friedrich Esslinger, Veronika Lummer, Heiner Nebelung, Leo Misera, Ralf-Thorsten Hoffmann, Johanna Kirchberg, Marius Distler, Jürgen Weitz, Daniel E Stange, Felix Merboth

Published in

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. Sep 03, 2026. Epub Sep 03, 2026.

Abstract

Sarcopenia is an important prognostic factor in gastrointestinal malignancies, but CT-based definitions vary. This study evaluated recently published computed tomography (CT)-based cut-offs for skeletal muscle index (SMI) and psoas muscle thickness normalized to height (PMTH), derived from a young, presumably healthy reference population according to recommendations of the European Working Group on Sarcopenia in Older People (EWGSOP), in patients undergoing surgery for gastric cancer.
This retrospective, single-center cohort study included patients who underwent surgery for gastric cancer between 2013 and 2018. Preoperative CT was used to assess SMI and PMTH. The recently published reference cut-offs were compared with the established definitions of Prado et al. (SMI) and Gu et al. (PMTH). Overall survival (OS) and recurrence-free survival (RFS) were the primary and secondary endpoints, respectively.
Data from 212 patients with complete 5-year follow-up were analyzed. The reference cut-offs significantly discriminated OS and RFS (SMI, both p < 0.001; PMTH, both p = 0.002), whereas the established cut-offs showed weaker or no discrimination. Patients with both low SMI and low PMTH had the worst OS and RFS (both p < 0.001). Combined low SMI and low PMTH was associated with worse OS in univariable analysis (HR 2.57, 95% CI 1.54-4.30, p < 0.001) and remained independently associated in multivariable analysis (HR 1.83, 95% CI 1.01-3.30; p = 0.046).
The recently published CT-based reference cut-offs for SMI and PMTH provided consistent prognostic stratification after gastric cancer resection, and their combined use identified patients with particularly poor long-term survival.

PMID:
42690608
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.