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Association of low skeletal muscle mass and radiodensity with clinical outcomes in patients undergoing robotic radical gastric cancer surgery: a population-based retrospective cohort study

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机构: [1]The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China [2]Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang 050011, China [3]Big Data Analysis and Mining Application for Precise Diagnosis and Treatment of Gastric Cancer, Hebei Provincial Engineering Research Center, Shijiazhuang 050011, China [4]The Department of CT/MRI, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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关键词: Gastric cancer Robotic surgery Skeletal muscle index Skeletal muscle radiodensity Postoperative complications Long-term prognosis

摘要:
Sarcopenia (defined as low skeletal muscle index - SMI) and myosteatosis (defined as low skeletal muscle radiodensity - SMD) associate with poor outcomes in gastric cancer, but their impact after robotic surgery is unknown.This retrospective cohort study analyzed 381 gastric cancer patients undergoing robotic surgery from December 2019 to October 2022. Sarcopenia and myosteatosis were assessed on preoperative CT scans. Outcomes were postoperative complications, mortality, survival, and recurrence. Multivariable regression and propensity score matching examined associations.The mean age at diagnosis was 58.5 ± 10.8 years, and 69.3% (262/381) were male. Low SMI or Low SMD independently associated with more complications (odds ratio[OR] = 3.36, 95%CI: 2.08-5.43; OR = 2.49,95%CI: 1.48-4.19, respectively), unplanned ICU admission (OR = 1.51, 95%CI: 1.22-8.44; OR = 2.00; 95%CI: 1.23-8.89, respectively) or 30-day mortality (OR = 5.89, 95%CI: 1.80-14.23; OR = 7.34; 95%CI: 2.43-18.67, respectively). Concurrent sarcopenia and myosteatosis heightened risks of complications (OR = 7.29, 95%CI: 1.62-42.30), severe complications (OR = 6.67, 95%CI: 2.22-12.68), 30-day mortality (OR = 9.55, 95%CI: 2.67-33.89), and reduced survival (hazard ratio[HR] = 3.09, 95%CI: 1.77-8.60).Sarcopenia and myosteatosis independently and additively associate with increased postoperative complications, mortality, and worse prognosis after robotic gastric cancer surgery. Identifying sarcopenia and myosteatosis preoperatively could inform risk assessments and guide management to improve surgical outcomes.© 2025. The Author(s).

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出版当年[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
第一作者:
第一作者机构: [1]The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China [2]Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang 050011, China [3]Big Data Analysis and Mining Application for Precise Diagnosis and Treatment of Gastric Cancer, Hebei Provincial Engineering Research Center, Shijiazhuang 050011, China
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通讯作者:
通讯机构: [1]The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China [2]Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang 050011, China [3]Big Data Analysis and Mining Application for Precise Diagnosis and Treatment of Gastric Cancer, Hebei Provincial Engineering Research Center, Shijiazhuang 050011, China
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