Muscle strength is a stronger prognostic factor than muscle mass in patients with gastrointestinal and hepatobiliary pancreatic cancers

Objective: Sarcopenia have been reported as a prognostic risk factor in patients with　gastrointestinal (GI) and hepatobiliary-pancreatic (HBP) cancers. This study aimed to investigate whether the loss of muscle mass or strength is a stronger prognostic factor and explore the cutoff values of skeletal muscle mass index (SMI) and handgrip strength (HGS) based on the survival outcome in patients with GI and HBP cancers.
Methods: A total of 480 elderly patients with primary GI and HBP cancers who underwent their first resection surgery were analyzed retrospectively. The patients were divided into four groups: appropriate SMI and HGS, low SMI alone, low HGS alone, and low SMI and HGS. Low SMI derived from a bioelectrical impedance analysis and low HGS were defined according to the Asian Working Group for Sarcopenia 2019 criteria.
Results: Multivariate analysis showed that the low SMI was a significant risk factor for mortality only in men, while the low HGS was significant in both sexes. From the multivariate analysis of the four groups, the low HGS alone and low SMI and HGS showed a significantly higher hazard ratio than appropriate SMI and HGS in both sexes. SMI 7.21 kg/m2 and HGS 28 kg were obtained as cutoff values based on the 3-year survival outcomes in men.
Conclusion: Low muscle strength was a stronger prognostic factor than low muscle mass. Therefore, it is essential to measure muscle strength in all the patients.

© 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/