Impact of sarcopenia on outcomes following intra-arterial therapy of hepatic malignancies.
Impact of sarcopenia on outcomes following intra-arterial therapy of hepatic malignancies.
复制标题
DOI：
10.1007/s11605-013-2348-5
复制
发表时间：
2013-12
影响因子：
3.2
通讯作者：
Pawlik, Timothy M.
中科院分区：
文献类型：
--
作者：
Dodson, Rebecca M.;Firoozmand, Amin;Hyder, Omar;Tacher, Vania;Cosgrove, David P.;Bhagat, Nikhil;Herman, Joseph M.;Wolfgang, Christopher L.;Geschwind, Jean-Francois H.;Kamel, Ihab R.;Pawlik, Timothy M.
对患者表现状态的评估通常是主观的。骨质疏松症--肌肉损耗的测量--可能是评估动脉内治疗(IAT)后的运动状态和死亡风险的更客观的手段。对2002年至2012年间216例肝脏恶性肿瘤行IAT术患者的腰大肌总面积(TPA)进行了横断面影像测量。骨质疏松症被定义为最低性别特定四分位数的TPA。骨质疏松症的影响被评估与其他临床病理因素相关。IAT的适应症包括肝细胞癌(51%)、肝内胆管细胞癌(13%)、结直肠肝转移(7%)或其他转移性疾病(30%)。男性TPA中位数(568 mm2/m2)高于女性(413 mm2/m2)。IAT包括常规化疗栓塞术(54%)、药物洗脱微球(40%)或~(90)Y(6%)。肿瘤平均大小为5.8 cm，多为多发(74%)。90天死亡率为9.3%，3年生存率为39%。与死亡风险相关的因素有肿瘤大小(HR=1.84)和Child‘s评分(HR=2.15)(均P<0.05)。在多变量分析中，骨质疏松症仍然与死亡风险的增加独立相关(最低与最高TPA四分位数，HR=1.84；P=0.04)。骨钙素患者的3年存活率为28%，而非骨钙素患者的3年生存率为44%。骨量减少是IAT后死亡率的独立预测因素，骨量减少的患者死亡风险增加两倍。骨质疏松症是衡量肝脏疾病脆弱程度的客观指标，有助于临床对肝脏恶性肿瘤进行IAT治疗的决策。
Assessment of patient performance status is often subjective. Sarcopenia—measurement of muscle wasting—may be a more objective means to assess performance status and therefore mortality risk following intra-arterial therapy (IAT). Total psoas area (TPA) was measured on cross-sectional imaging in 216 patients undergoing IATof hepatic malignancies between 2002 and 2012. Sarcopenia was defined as TPA in the lowest sex-specific quartile. Impact of sarcopenia was assessed relative to other clinicopathological factors. Indications for IAT included hepatocellular carcinoma (51 %), intrahepatic cholangiocarcinoma (13 %), colorectal liver metastasis (7 %), or other metastatic disease (30 %). Median TPA among men (568 mm2/m2) was greater than women (413 mm2/m2). IAT involved conventional chemoembolization (54 %), drug-eluting beads (40 %), or yttrium-90 (6 %). Median tumor size was 5.8 cm; most patients had multiple lesions (74 %). Ninety-day mortality was 9.3 %; 3-year survival was 39 %. Factors associated with risk of death were tumor size (HR=1.84) and Child's score (HR=2.15) (all P <0.05). On multivariate analysis, sarcopenia remained independently associated with increased risk of death (lowest vs. highest TPA quartile, HR=1.84; P =0.04). Sarcopenic patients had a 3-year survival of 28 vs. 44 % for non-sarcopenic patients. Sarcopenia was an independent predictor of mortality following IAT with sarcopenic patients having a twofold increased risk of death. Sarcopenia is an objective measure of frailty that can help clinical decision-making regarding IAT for hepatic malignancies.
登录
查看更多内容
DOI：
10.1016/j.jamcollsurg.2010.03.039
发表时间：
2010-08
影响因子：
5.2
作者：
Englesbe, Michael J.;Patel, Shaun P.;He, Kevin;Lynch, Raymond J.;Schaubel, Douglas E.;Harbaugh, Calista;Holcombe, Sven A.;Wang, Stewart C.;Segev, Dorry L.;Sonnenday, Christopher J.
通讯作者：
Sonnenday, Christopher J.
影响因子：
29.4
作者：
Geschwind, JFH;Salem, R;Goin, JE
通讯作者：
Goin, JE
影响因子：
45.3
作者：
Hendlisz, Alain;Van den Eynde, Marc;Flamen, Patrick
通讯作者：
Flamen, Patrick
DOI：
10.2214/ajr.10.4770
发表时间：
2011-04
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Jin B;Wang D;Lewandowski RJ;Riaz A;Ryu RK;Sato KT;Larson AC;Salem R;Omary RA
通讯作者：
Omary RA
影响因子：
45.3
作者：
Antoun, Sami;Birdsell, Laura;Baracos, Vickie E.
通讯作者：
Baracos, Vickie E.