Association between CT-Based Preoperative Sarcopenia and Outcomes in Patients That Underwent Liver Resections.
Association between CT-Based Preoperative Sarcopenia and Outcomes in Patients That Underwent Liver Resections.
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DOI：
10.3390/cancers14010261
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发表时间：
2022-01-05
期刊：
影响因子：
5.2
通讯作者：
Uldry E
中科院分区：
文献类型：
--
作者：
Martin D;Maeder Y;Kobayashi K;Schneider M;Koerfer J;Melloul E;Halkic N;Hübner M;Demartines N;Becce F;Uldry E
癌症恶病质通常包括肌肉减少症，其特征在于骨骼肌质量和强度的进行性、全身性损失，并伴有脂肪浸润到肌肉中。肌肉减少症被认为是预测癌症手术后结果的患者特异性成像生物标志物。本研究旨在评估术前肌肉减少症是否与接受肝切除术的患者的术后结局和生存率相关。通过术前CT成像评估，三分之二的患者存在肌肉减少症。肌肉减少症的独立危险因素为年龄、男性、阿萨评分≥ 3和恶性肿瘤。仅根据CT评估，肌肉减少症对肝切除术后的临床结局或总生存率没有影响。这项回顾性观察性研究旨在评估术前肌肉减少症（通过CT成像评估）是否与接受肝切除术的患者的术后临床结局和总生存率相关。纳入了2014年1月至2020年2月期间手术的患者。在术前CT扫描上测量第三腰椎水平的骨骼肌指数（SMI）。根据预先确定的SMI临界值定义术前肌肉减少症。结果为术后发病率、住院时间（LOS）和总生存率。在355例患者中，212例（59.7%）术前有肌肉减少症。与无肌肉减少症的患者相比（分别为59.3岁，p < 0.01和27.7 kg/m2，p <0.01），患有肌肉减少症的患者年龄明显更大（63.5岁），BMI（23.9 kg/m2）明显更低。LOS无差异（8天vs. 8天，p = 0.75），两组之间的重大并发症发生率相当（11.2% vs. 11.3%，p = 1.00）。肌肉减少症患者和非肌肉减少症患者的中位总生存时间相当（15个月vs. 16个月，p = 0.87）。仅基于CT评估，术前肌肉减少似乎对接受肝切除术的患者的术后临床结局或总生存率没有影响。未来的努力还应考虑肌肉力量和身体表现，除了成像，术前风险分层。
Cancer cachexia often includes sarcopenia, which is characterized by a progressive, generalized loss of skeletal muscle mass and strength, combined with fatty infiltration into the muscle. Sarcopenia has been considered a patient-specific imaging biomarker for predicting outcomes after cancer surgery. The present study aimed to evaluate whether preoperative sarcopenia was associated with postoperative outcomes and survival in patients that underwent liver resections. Sarcopenia, assessed by preoperative CT imaging, was present in two-thirds of patients. Independent risk factors for sarcopenia were age, male sex, ASA score ≥ 3, and malignancies. Based on CT assessment alone, sarcopenia had no impact on clinical outcomes or overall survival after hepatectomy. This retrospective observational study aimed to evaluate whether preoperative sarcopenia, assessed by CT imaging, was associated with postoperative clinical outcomes and overall survival in patients that underwent liver resections. Patients operated on between January 2014 and February 2020 were included. The skeletal muscle index (SMI) was measured at the level of the third lumbar vertebra on preoperative CT scans. Preoperative sarcopenia was defined based on pre-established SMI cut-off values. The outcomes were postoperative morbidity, length of hospital stay (LOS), and overall survival. Among 355 patients, 212 (59.7%) had preoperative sarcopenia. Patients with sarcopenia were significantly older (63.5 years) and had significantly lower BMIs (23.9 kg/m2) than patients without sarcopenia (59.3 years, p < 0.01, and 27.7 kg/m2, p < 0.01, respectively). There was no difference in LOS (8 vs. 8 days, p = 0.75), and the major complication rates were comparable between the two groups (11.2% vs. 11.3%, p = 1.00). The median overall survival times were comparable between patients with sarcopenia and those without sarcopenia (15 vs. 16 months, p = 0.87). Based on CT assessment alone, preoperative sarcopenia appeared to have no impact on postoperative clinical outcomes or overall survival in patients that underwent liver resections. Future efforts should also consider muscle strength and physical performance, in addition to imaging, for preoperative risk stratification.
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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.
DOI：
10.1111/apha.12224
发表时间：
2014-03
期刊：
Acta physiologica (Oxford, England)
影响因子：
--
作者：
Aubrey J;Esfandiari N;Baracos VE;Buteau FA;Frenette J;Putman CT;Mazurak VC
通讯作者：
Mazurak VC
影响因子：
--
作者：
Carli, Francesco;Scheede-Bergdahl, Celena
通讯作者：
Scheede-Bergdahl, Celena
影响因子：
3.8
作者：
Franken, Lotte C.;Schreuder, Anne Marthe;van Gulik, Thomas M.
通讯作者：
van Gulik, Thomas M.
影响因子：
2.6
作者：
Graffy, Peter M.;Liu, Jiamin;Summers, Ronald M.
通讯作者：
Summers, Ronald M.