Introduction : The impact of sarcopenia on the prognosis for patients with gallbladder cancer (GBC) is unclear. The aim of this study was to determine the prognostic significance of sarcopenia in patients with GBC.

Methods : From March 2001 to December 2013, 158 patients with GBC who underwent curative intent surgery were included in this study. Patients were classified into two groups according to the presence or absence of sarcopenia, which was based on the calculated skeletal muscle mass index (SMI) using abdominal computed tomography.

Results : The 1-, 3-, and 5-year overall survival (OS) rates were 63.6%, 41.9%, and 36.4%, respectively, for patients with sarcopenia, and 84.3%, 62.6%, and 54.3%, respectively, for those without sarcopenia (P = 0.006). However, recurrence-free survival (RFS) rates did not show any difference according to sarcopenia status (P = 0.490). Multivariate analysis showed that sarcopenia (hazard rate [HR] 1.704, P = 0.024) was a significant prognostic factor for patient survival, as well as disease stage (IV: HR 7.181, P < 0.001), radicality (HR 2.830, P = 0.001), adjuvant therapy (HR 0.537, P = 0.017), and intraoperative blood loss ≥ 1 L (HR 1.851, P = 0.023).

Conclusions : This study confirmed that a significant association existed between preoperative sarcopenia and survival in patients with GBC. Because sarcopenia is the only prognostic factor that can be evaluated before surgery, its evaluation would enable early preventive therapy, allowing the maintenance of muscle mass and patient-specific treatment planning according to their physiologic reserves, i.e., skeletal muscle mass.