ArticleSAGE open medicine2026
Construction and evaluation of a prediction model for postoperative low muscle mass in older adult patients with gastric cancer.
Article in SAGE open medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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