Factors predicting skeletal muscle mass loss after gastric cancer surgery: a retrospective observational study

120 Background: Our previous study clarified that morbidity was a negative prognostic factor and sarcopenia defined by of the handgrip strength was a risk factor for the morbidity in gastric cancer surgery. Sarcopenia was reportedly a negative prognostic factor in colorectal cancer, hepatocellular carcinoma and malignant melanoma. This study aimed to evaluate impact of preoperative sarcopenia on recurrence-free survival (RFS) in gastric cancer surgery. Methods: Between May 2011 and June 2013, 256 consecutive primary gastric cancer patients who underwent curative surgery were retrospectively examined. Patients who received neoadjuvant chemotherapy or were diagnosed with pathological stage IV were excluded. Preoperative skeletal muscle mass was evaluated by bioelectrical impedance analysis and was expressed as skeletal muscle index or SMI (muscle mass/height2) by adjusting absolute muscle mass with height. Preoperative muscle function was measured by hand grip strength (HGS). Each cutoff value was determined as the gender-specific lowest 20% of the distribution of each measurement. Univariate and multivariate analyses were preformed to identify risk factors for RFS using a Cox proportional hazards model. Results: Median age (range) was 66 years (37-85 years). Male to female ratio was 168:88. Median follow-up period was 33.4 months. Pathological stage was I in 160, II in 48 and III in 48 patients. Univariate analysis showed that age, adjuvant chemotherapy, pT, pN, histological type, tumor size, total gastrectomy, low SMI and low HGS were significant risk factors for RFS. Multi-variate Cox’s proportional hazard analyses demonstrated that pT (HR 2.76, p = 0.0001), pN (HR 1.375, p = 0.037), histological type (HR 3.46, p = 0.014), low SMI (HR2.17, p = 0.036) were the significant risk factors for RFS. The three-year RFS was 89.1% in the patients with high SMI and 73.2% in those with low SMI (p = 0.007). Conclusions: Low SMI was an independent risk factor for RFS in Stage I-III gastric cancer. Low HGS, a risk factor for morbidity shown in our previous study, was not a risk independent factor for RFS. Preoperative sarcopenia as the short- and long-term outcomes has a value to be tested in the future prospective studies in gastric cancer surgery.

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Supplementation of protein-free diet with whey protein hydrolysates prevents skeletal muscle mass loss in rats

Journal of Nutrition & Intermediary Metabolism ◽

10.1016/j.jnim.2016.03.001 ◽

2016 ◽

Vol 4 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Yodai Kobayashi ◽

Yuuki Somoto ◽

Eri Mitsuyama ◽

Azusa Tanaka ◽

Naoki Yuda ◽

...

Keyword(s):

Skeletal Muscle ◽

Mass Loss ◽

Whey Protein ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Protein Hydrolysates ◽

Whey Protein Hydrolysates ◽

Muscle Mass Loss ◽

Protein Free Diet

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Loss of Skeletal Muscle Mass Affects the Incidence of Minimal Hepatic Encephalopathy: A Case Control Study

10.21203/rs.3.rs-42056/v1 ◽

2020 ◽

Author(s):

Masakuni Tateyama ◽

Hideaki Naoe ◽

Motohiko Tanaka ◽

Kentaro Tanaka ◽

Satoshi Narahara ◽

...

Keyword(s):

Skeletal Muscle ◽

Liver Cirrhosis ◽

Hepatic Encephalopathy ◽

Mass Loss ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Lumbar Vertebra ◽

Minimal Hepatic Encephalopathy ◽

Skeletal Muscle Index ◽

Muscle Mass Loss

Abstract Background: Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy.Methods: To clarify the relationship between minimal hepatic encephalopathy and sarcopenia and/or muscle mass loss in patients with liver cirrhosis. Ninety-nine patients with liver cirrhosis were enrolled. Minimal hepatic encephalopathy was diagnosed by a neuropsychiatric test. Skeletal mass index was calculated by dividing muscle area at the third lumbar vertebra by the square of height in meters.Results: MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. Skeletal muscle index was smaller in patients with minimal hepatic encephalopathy (46.4 cm2/m2) than in those without (51.2 cm2/m2, P = 0.027). Skeletal muscle index represented a predictive factor related to minimal hepatic encephalopathy (<50 cm2/m2; odds ratio 0.300, P = 0.002).Conclusions: Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.

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Loss of skeletal muscle mass affects the incidence of minimal hepatic encephalopathy: A case control study

10.21203/rs.3.rs-42056/v3 ◽

2020 ◽

Author(s):

Masakuni Tateyama ◽

Hideaki Naoe ◽

Motohiko Tanaka ◽

Kentaro Tanaka ◽

Satoshi Narahara ◽

...

Keyword(s):

Skeletal Muscle ◽

Hepatic Encephalopathy ◽

Mass Loss ◽

Muscle Mass ◽

Odds Ratio ◽

Skeletal Muscle Mass ◽

Psoas Muscle ◽

Minimal Hepatic Encephalopathy ◽

Muscle Area ◽

Muscle Mass Loss

Abstract Background: Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy (MHE).Methods: To clarify the relationship between MHE and sarcopenia and/or muscle mass loss in patients with liver cirrhosis.Methods: Ninety-nine patients with liver cirrhosis were enrolled. MHE was diagnosed by a neuropsychiatric test. Skeletal mass index (SMI) and Psoas muscle index (PMI) were calculated by dividing skeletal muscle area and psoas muscle area at the third lumbar vertebra by the square of height in meters, respectively, to evaluate muscle volume.Results: This study enrolled 99 patients (61 males, 38 females). MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. SMI was smaller in patients with MHE (46.4 cm2/m2) than in those without (51.2 cm2/m2, P = 0.027). Similarly, PMI was smaller in patients with MHE (4.24 cm2/m2) than in those without (5.53 cm2/m2, P = 0.003). Skeletal muscle volume, which is represented by SMI or PMI was a predictive factor related to MHE (SMI ≥ 50 cm2/m2; odds ratio 0.300, P = 0.002, PMI ≥ 4.3 cm2/m2; odds ratio 0.192, P = 0.001).Conclusions: Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.

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Impact of Preoperative Skeletal Muscle Mass and Nutritional Status on Short-and Long-Term Outcomes After Esophagectomy for Esophageal Cancer: A Retrospective Observational Study

Annals of Surgical Oncology ◽

10.1245/s10434-019-07188-z ◽

2019 ◽

Vol 26 (5) ◽

pp. 1301-1310 ◽

Cited By ~ 6

Author(s):

Toshiaki Shichinohe ◽

Shion Uemura ◽

Satoshi Hirano ◽

Masao Hosokawa

Keyword(s):

Skeletal Muscle ◽

Esophageal Cancer ◽

Observational Study ◽

Nutritional Status ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Retrospective Observational Study ◽

Long Term Outcomes ◽

Short And Long Term

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Skeletal muscle mass loss and dose‐limiting toxicities in metastatic colorectal cancer patients

Journal of Cachexia Sarcopenia and Muscle ◽

10.1002/jcsm.12436 ◽

2019 ◽

Vol 10 (4) ◽

pp. 803-813 ◽

Cited By ~ 13

Author(s):

Sophie Kurk ◽

Petra Peeters ◽

Rebecca Stellato ◽

B. Dorresteijn ◽

Pim Jong ◽

...

Keyword(s):

Colorectal Cancer ◽

Skeletal Muscle ◽

Mass Loss ◽

Metastatic Colorectal Cancer ◽

Cancer Patients ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Muscle Mass Loss ◽

Colorectal Cancer Patients

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Impact of preoperative sarcopenia on morbidity in gastric cancer surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.40 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 40-40

Author(s):

Tsutomu Sato ◽

Toru Aoyama ◽

Tsutomu Hayashi ◽

Haruhiko Cho ◽

Taiichi Kawabe ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Risk Factor ◽

Grip Strength ◽

Muscle Mass ◽

Significant Risk ◽

Significant Risk Factor ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Hand Grip

40 Background: Skeletal muscle depletion, known as sarcopenia, is characterized by decrease in muscle mass and function. Recent reports demonstrated that sarcopenia was a significant risk factor for complications in colorectal cancer surgery. This study aimed to evaluate impact of preoperative sarcopenia on morbidity in gastric cancer surgery. Methods: Between May 2011 and June 2013, 293 consecutive primary gastric cancer patients who underwent curative surgery were retrospectively examined. All patients received the same perioperative care of enhanced recovery after surgery program. Preoperative skeletal muscle mass was evaluated by bioelectrical impedance analysis and was expressed as skeletal muscle index or SMI (muscle mass/height2) by adjusting absolute muscle mass with height. Preoperative muscle function was measured by hand grip strength (HGS). Each cutoff value was determined as the gender-specific lowest 20% of the distribution of each measurement. Grade 2 or higher morbidity, evaluated by Clavien-Dindo classification, was picked-up from the patient record. Risk factor for morbidity was examined by uni- and multi-variate analyses. Results: Median age (range) was 68 years (37-85 years). Male to female ratio was 192:101. Operative procedure was 122 total, 169 distal, and 2 proximal gastrectomy. Lymphadenectomy was 162 D1+ and 131 D2 including 53 splenectomy. Pathological stage was I in 149, II in 39, III in 91, and IV in 14 patients. Morbidity included 7 pancreatic leakage, 12 anastomotic leakage, 4 intra-abdominal abscess, and others. In total, morbidity was observed in 39 patients (13.3%); 21 in grade 2, 16 in grade 3a, 1 in grade 3b, and 1 in grade 4. No mortality was observed. Univariate analysis showed that male, total gastrectomy, splenectomy, and low HGS were significant risk factor for morbidity. Low SMI was not a risk factor. By multi-variate analysis, low HGS(HR 2.457, p=0.029), male(HR 2.610, p=0.038)and total gastrectomy(HR 2.747, p=0.027)remained significant. Conclusions: Low hand grip strength was one of significant risk factor for morbidity in gastric cancer surgery. Hand grip strength as a surgical risk has a value to be examined in the future prospective studies.

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