Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer
Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer
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DOI：
10.1007/s00330-015-3963-1
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发表时间：
2016-05-01
影响因子：
5.9
通讯作者：
Ba-Ssalamah, Ahmed
中科院分区：
文献类型：
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作者：
Tamandl, Dietmar;Paireder, Matthias;Ba-Ssalamah, Ahmed
目的评估肌肉减少症和身体组成参数（BCP）改变对食管和胃食管连接部癌（OC）手术后生存率的影响。方法选择2006年至2013年期间接受OC切除术的200例连续患者。术前CT用于评估肌肉减少症和身体成分的标志物（总肌肉面积[TMA]、去脂肪质量指数[FFMi]、脂肪质量指数[FMi]、皮下、内脏和肾后脂肪[RRF]、肌肉衰减）。结果130例（65%）患者术前CT检查有肌肉减少症。与非肌肉减少症个体相比，肌肉减少症患者的生存率受损（风险比[HR] 1.87，95%置信区间[CI] 1.15-3.03，p = 0.011）。此外，低骨骼肌衰减（HR 1.91，95% CI 1.12-3.28，p = 0.019）和FMi增加（HR 3.47，95% CI 1.27-9.50，p = 0.016）与结局受损相关。在多变量分析中，包括这三个参数和临床变量的综合评分（CSS），只有CSS，T分期和手术切除边缘仍然是OS的显着预测。结论患者显示肌肉减少症的迹象和改变BCP术前CT图像受损的长期预后OC手术后。
Objectives To assess the impact of sarcopenia and alterations in body composition parameters (BCPs) on survival after surgery for oesophageal and gastro-oesophageal junction cancer (OC).Methods 200 consecutive patients who underwent resection for OC between 2006 and 2013 were selected. Preoperative CTs were used to assess markers of sarcopenia and body composition (total muscle area [TMA], fat-free mass index [FFMi], fat mass index [FMi], subcutaneous, visceral and retrorenal fat [RRF], muscle attenuation). Cox regression was used to assess the primary outcome parameter of overall survival (OS) after surgery.Results 130 patients (65 %) had sarcopenia based on preoperative CT examinations. Sarcopenic patients showed impaired survival compared to non-sarcopenic individuals (hazard ratio [HR] 1.87, 95 % confidence interval [CI] 1.15-3.03, p = 0.011). Furthermore, low skeletal muscle attenuation (HR 1.91, 95 % CI 1.12-3.28, p = 0.019) and increased FMi (HR 3.47, 95 % CI 1.27-9.50, p = 0.016) were associated with impaired outcome. In the multivariate analysis, including a composite score (CSS) of those three parameters and clinical variables, only CSS, T-stage and surgical resection margin remained significant predictors of OS.Conclusion Patients who show signs of sarcopenia and alterations in BCPs on preoperative CT images have impaired long-term outcome after surgery for OC.