Prognostic value and association of the age-adjusted Charlson Comorbidity Index with sarcopenia within patients with gastric cancer following radical resection

Purpose The association between the age-adjusted Charlson Comorbidity Index (ACCI) and sarcopenia in patients with gastric cancer (GC) remains ambiguous. Our study aimed to investigate the connection between ACCI and sarcopenia and the prognostic value in patients with GC following radical resection. Additionally, we sought to develop a novel prognostic scoring system based on these factors. Materials and methods Univariate and multivariate Cox regression analyses were used to determine prognostic factors in patients undergoing radical GC resection. Based on the ACCI and sarcopenia, a new prognostic score (ACCIS) was established, and its prognostic value was assessed. Results We included 1068 patients with GC in our study. Multivariate analysis revealed that ACCI and sarcopenia were independent risk factors during the prognosis of GC (p=0.001 and p<0.001, respectively). A greater ACCI score independently predicted sarcopenia (p=0.014). A high ACCIS score was linked to a greater American Society of Anesthesiologists score, higher pathological tumor-node-metastasis (pTNM) stage, and larger tumor size (all p<0.05). Multivariate analysis demonstrated that the ACCIS independently predicted the prognosis for those patients with GC (p<0.001). By incorporating the ACCIS score into a prognostic model with sex, pTNM stage, tumor size, and tumor differentiation, we constructed a nomogram to predict the prognosis accurately (C-index of 0.741). Conclusion The ACCI score and sarcopenia are significantly correlated in patients with GC. The integration of ACCI score and sarcopenia markedly enhances the accuracy of prognostic predictions in patients with GC.