Sarcopenia in patients with normal body mass index is an independent predictor for postoperative complication and long-term survival in gastric cancer.

Malnutrition in gastric cancer patients with normal body mass index (BMI) is often ignored. This study aimed to explore the role of sarcopenia in predicting postoperative complication and long-term survival in gastric cancer patients with normal BMI. We included patients with normal BMI (18.5 kg/m2 ≤ BMI ＜ 23 kg/m2 ) who underwent radical gastrectomy between July 2014 and December 2016. Sarcopenia was assessed by muscle mass, handgrip strength, and gait speed. Kaplan-Meier survival analysis was used to analyze the association between sarcopenia and the prognosis of gastric cancer patients. Univariate and multivariate analyses were used to identify risk factors contributing to postoperative complications and long-term survival. Overall, 267 gastric cancer patients with normal BMI were included in this study; of which, 49 (18.35%) patients were diagnosed with sarcopenia. Sarcopenia patients had higher incidence of a major postoperative complication, longer postoperative hospital stays, and greater hospital costs. The Kaplan-Meier survival analysis showed that sarcopenia patients had poorer overall survival than non-sarcopenia patients. Univariate and multivariate analyses showed that sarcopenia was an independent predictor for postoperative complication and long-term survival in such patients. Sarcopenia is an independent predictor for postoperative complication and long-term survival in patients with normal BMI after radical gastrectomy for gastric cancer. We recommend that patients with normal BMI should perform nutritional risk screening by sarcopenia.