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

Dingye Yu; Weizhe Chen; Fengmin Zhang; Hongting Huang; Tianyu Yu; Guowei Huang; Haojie Jiang; Qiantong Dong; Zhen Yu; Jiyu Li

doi:10.1016/j.ejso.2025.110299

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

Eur J Surg Oncol. 2025 Jun 27;51(10):110299. doi: 10.1016/j.ejso.2025.110299. Online ahead of print.

Authors

Dingye Yu¹, Weizhe Chen², Fengmin Zhang², Hongting Huang³, Tianyu Yu¹, Guowei Huang⁴, Haojie Jiang⁴, Qiantong Dong⁴, Zhen Yu⁵, Jiyu Li⁶

Affiliations

¹ Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China.
² Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
³ Department of Liver Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.
⁴ Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325005, Zhejiang Province, China.
⁵ Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China. Electronic address: yuzhen@tongji.edu.cn.
⁶ Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China. Electronic address: lijiyu@fudan.edu.cn.

PMID: 40588428
DOI: 10.1016/j.ejso.2025.110299

Abstract

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.

Keywords: Gastric cancer; Laparoscopic radical gastrectomy; Prognosis; Sarcopenia.