SAGE Open Medicine · Published 2026-07-01 · DOI 10.1177/20503121261469844
Linfang Li, Rong Zhang, Yuexuan Liu, Bai Li, Zhihui Zhang, Han Sun, Shuhua Wu
Background With global population aging, the prevalence of gastric cancer among patients aged 60 years and older continues to rise. Radical gastrectomy frequently induces postoperative skeletal muscle loss, which correlates with poor clinical prognosis. Currently, few prediction models are available to screen for new-onset postoperative low muscle mass in older gastric cancer patients. This study aimed to construct and internally validate a preoperative prediction model for low muscle mass at six months after radical gastrectomy in this elderly population. Methods A total of 69 eligible older adult patients with pTNM stage I–III gastric adenocarcinoma were retrospectively enrolled. Those with preoperative low muscle mass, neoadjuvant therapy, or incomplete clinical and imaging data were excluded. Postoperative low muscle mass was diagnosed using L3-level skeletal muscle index based on Asian cutoff criteria. Univariate and multivariate logistic regression analyses were applied to screen independent predictors. Model performance was assessed via ROC curves, calibration curves, and leave-one-out cross-validation (LOOCV). Results Among all participants, 17 patients (24.6%) developed postoperative low muscle mass. Preoperative BMI, skeletal muscle area, lymphocyte-monocyte ratio, and surgical method were confirmed as independent influencing factors. The established model yielded an AUC of 0.857, with a sensitivity of 94.1% and specificity of 67.3%, and the LOOCV AUC reached 0.832. Total gastrectomy was linked to a higher risk of low muscle mass compared with partial gastrectomy. Conclusions Preoperative BMI, SMA, and LMR can independently predict postoperative low muscle mass in older adult gastric cancer patients. The model shows moderate-to-good predictive performance in this single-center cohort and may help identify high-risk patients preoperatively. Prioritizing partial gastrectomy when oncologically safe and providing preoperative nutritional and exercise support may help reduce muscle loss.
Abstract from DOAJ. Public domain (CC0 1.0).
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Li, L., Zhang, R., Liu, Y., et al. (2026). Construction and evaluation of a prediction model for postoperative low muscle mass in older adult patients with gastric cancer. SAGE Open Medicine. https://doi.org/10.1177/20503121261469844