Impact Total Psoas Volume on Short- and Long-Term Outcomes in Patients Undergoing Curative Resection for Pancreatic Adenocarcinoma: a New Tool to Assess Sarcopenia.
Impact Total Psoas Volume on Short- and Long-Term Outcomes in Patients Undergoing Curative Resection for Pancreatic Adenocarcinoma: a New Tool to Assess Sarcopenia.
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DOI：
10.1007/s11605-015-2835-y
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Pawlik TM
中科院分区：
文献类型：
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作者：
Amini N;Spolverato G;Gupta R;Margonis GA;Kim Y;Wagner D;Rezaee N;Weiss MJ;Wolfgang CL;Makary MM;Kamel IR;Pawlik TM
虽然肌肉减少症通常使用总腰肌面积（TPA）定义，但仅使用单个轴向横截面图像表征肌肉减少症可能是不够的。我们试图评估腰大肌总体积（TPV），作为定义肌肉减少症并比较相对于TPA和TPV的患者结局的新工具。对1996年至2014年期间因胰腺癌接受胰腺切除术的763例患者进行了肌肉减少症评估。其定义为最低性别特异性四分位数中的TPA和TPV。使用多变量分析评估TPA和TPV定义的肌肉减少症对总体发病率和死亡率的影响。女性TPA和TPV的中位数均低于男性（均P<0.001）。TPA确定了192例（25.1%）肌肉减少症患者，而TPV确定了152例（19.9%）患者。369例（48.4%）患者发生术后并发症。虽然TPA-肌肉减少症与术后并发症的高风险无关（OR 1.06; P=0.72），但TPV定义的肌肉减少症与发病率相关（OR 1.79; P=0.002）。在多变量分析中，TPV-肌肉减少症仍然与术后并发症风险增加（OR 1.69; P=0.006）以及长期生存率（HR 1.46; P=0.006）独立相关。使用TPV定义肌肉减少症与胰腺癌切除术后的短期和长期结局相关。腰大肌（TPV）的整个体积的评估可能是一个更好的手段来定义肌肉减少症，而不是一个单一的轴向图像。
While sarcopenia is typically defined using total psoas area (TPA), characterizing sarcopenia using only a single axial cross-sectional image may be inadequate. We sought to evaluate total psoas volume (TPV) as a new tool to define sarcopenia and compare patient outcomes relative to TPA and TPV. Sarcopenia was assessed in 763 patients who underwent pancreatectomy for pancreatic adenocarcinoma between 1996 and 2014. It was defined as the TPA and TPV in the lowest sex-specific quartile. The impact of sarcopenia defined by TPA and TPV on overall morbidity and mortality was assessed using multivariable analysis. Median TPA and TPV were both lower in women versus men (both P<0.001). TPA identified 192 (25.1 %) patients as sarcopenic, while TPV identified 152 patients (19.9 %). Three hundred sixty-nine (48.4 %) patients experienced a postoperative complication. While TPA-sarcopenia was not associated with higher risk of postoperative complications (OR 1.06; P=0.72), sarcopenia defined by TPV was associated with morbidity (OR 1.79; P=0.002). On multivariable analysis, TPV-sarcopenia remained independently associated with an increased risk of postoperative complications (OR 1.69; P=0.006), as well as long-term survival (HR 1.46; P=0.006). The use of TPV to define sarcopenia was associated with both short- and long-term outcomes following resection of pancreatic cancer. Assessment of the entire volume of the psoas muscle (TPV) may be a better means to define sarcopenia rather than a single axial image.