Prognostic significance of osteosarcopenia in patients with stage IV gastric cancer undergoing conversion surgery

Recently, several investigators have focused on the clinical significance of osteosarcopenia in malignancies; however, its prognostic impact on patients with gastric cancer after conversion surgery (CS) remains unclear. Therefore, we aimed to investigate sarcopenia, osteopenia, and osteosarcopenia in this patient population.

We retrospectively analyzed 24 patients with gastric cancer who underwent CS. Before CS, the skeletal muscle index at the L3 vertebra and bone mineral density at the Th11 vertebra were measured to investigate sarcopenia and osteopenia, respectively. Osteosarcopenia was defined as the coexistence of sarcopenia and osteopenia. The relationship between perioperative osteosarcopenia and patient prognosis, including clinicopathological factors, was assessed.

Among the 24 patients, 10 (42%) had osteosarcopenia. Osteosarcopenia was significantly correlated with body mass index, depth of tumor invasion, and tumor stage (all p < 0.05). The median overall survival and disease-free survival after CS in patients with osteosarcopenia were significantly shorter than those in patients without osteosarcopenia (all p < 0.05). In the multivariate analysis, osteosarcopenia was identified as an independent factor related to overall survival alone (p = 0.04).

Assessment of osteosarcopenia has clinical utility in predicting the prognosis after CS in patients with stage IV gastric cancer after chemotherapy.