Wu WY, Dong JJ, Huang XC, Chen ZJ, Chen XL, Dong QT, Bai YY. AWGS2019 vs EWGSOP2 for diagnosing sarcopenia to predict long-term prognosis in Chinese patients with gastric cancer after radical gastrectomy . World J Clin Cases 2021; 9(18): 4668-4680 [PMID: 34222433 DOI: 10.12998/wjcc.v9.i18.4668]
Corresponding Author of This Article
Yong-Yu Bai, MD, Surgeon, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou 325000, Zhejiang Province, China. baiyongyu@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen-Yi Wu, Zhe-Jing Chen, Xiao-Lei Chen, Qian-Tong Dong, Yong-Yu Bai, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Jiao-Jiao Dong, Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Xin-Ce Huang, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Bai YY and Dong QT designed the study; Huang XC, Wu WY, Dong JJ, and Chen ZJ collected the data; Chen ZJ and Chen XL analyzed and interpreted the data; Bai YY and Huang XC wrote the article; Dong JJ and Dong QT revised the article and took the decision to submit the article for publication.
Supported byZhejiang Provincial Health Department Medical Support Discipline-Nutrition, No. 11-ZC24; and Wenzhou Municipal Science and Bureau, No. Y2020732.
Institutional review board statement: This study was approved by the Ethical Review Board of the First Affiliated Hospital of Wenzhou Medical University (No. 2014063).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflict of interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Yu Bai, MD, Surgeon, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou 325000, Zhejiang Province, China. baiyongyu@qq.com
Received: February 6, 2021 Peer-review started: February 6, 2021 First decision: March 16, 2021 Revised: March 23, 2021 Accepted: April 20, 2021 Article in press: April 20, 2021 Published online: June 26, 2021 Processing time: 124 Days and 23.4 Hours
ARTICLE HIGHLIGHTS
Research background
Sarcopenia is a nutrition-related disease and has a profound effect on the long-term overall survival (OS) of patients with gastric cancer. Previous studies reported widely differing sarcopenia prevalence due to different criteria. AWGS2019 and EWGSOP2 are two latest and extensively adopted criteria.
Research motivation
To compare the effects of these two criteria on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.
Research objectives
To determine which method for diagnosing sarcopenia is more appropriate for Chinese gastric cancer patient after radical gastrectomy.
Research methods
An observational study was conducted from July 2014 to January 2017. Multivariate cox regression analysis was performed to determine the association of sarcopenia according to these two criteria separately with the long-term OS of these patients. The predictive performance of the models with AWGS2019 and EWGSOP2 was evaluated using the concordance index and area under the time-dependent receiver operating characteristic curve. The Akaike information criterion was used to compare model fits.
Research results
Sarcopenia was an independent risk factor for the long-term OS no matter based on AWGS2019 or EWGSOP2, but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio than EWGSOP2-sarcopenia. Meanwhile, the model with AWGS2019-sarcopenia had better predictive power and model fits than the model with EWGSOP2-sarcopenia.
Research conclusions
Sarcopenia based on both criteria is an independent risk factor for the long-term OS in Chinese patients undergoing radical gastrectomy for gastric cancer. The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia. AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.
Research perspectives
Surgeons should be aware of the importance of sarcopenia and pay close attention to the nutrition of these patients. Corresponding clinical interventions to ameliorate the effect of sarcopenia on the long-term OS need further evaluation in prospective clinical trials.
