scholarly journals The Effect of Sarcopenia on Postoperative Complications after Curative Pancreatectomy for Adenocarcinoma

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
ümit Mercan ◽  
Ogün Erşen ◽  
Ali Ekrem Ünal
Keyword(s):  
Pancreatic Cancer ◽  
Postoperative Complications ◽  
Curative Resection ◽  
Preoperative Staging ◽  
Psoas Muscle ◽  
Significant Relation ◽  
Muscle Area ◽  
Patient Demographics ◽  
Preoperative Ct ◽  
Independent Risk Factors

Objective: This study aimed to investigate the effect of sarcopenia on the development of serious postoperative complications in patients who underwent curative pancreatectomy for pancreatic cancer. Methods: Total psoas index (TPI) was calculated for sarcopenia diagnosis by measures of psoas muscle area on the level of L3 spine from preoperative staging computerised tomograhpy (CT) images in pancreatic cancer patients undergoing curative resection. Patient demographics and postoperative outcomes were analised  in sarcopenic and non-sarcopenic group. Results: It has been found to be statistically significant relation between severe postoperative complication and sarcopenia (p=0,001>). Sarcopenia was more associated with cardiac and pulmoner complications among others (p=0.007, p=0.003 respectively). In multivariate analysis, age (OR: 1,08. %95 CI: 1,01~1,15, p=0,013), ASA score (OR: 2,84. 95% CI 1,62 ~ 4,97. p= 0,043) and TPI (OR: 3,61. 95% CI: 1,58 ~ 5,74. p= 0,001>) has been found independent risk factors for severe postoperative complications.   Conclusion: Our results suggest that sarcopenia determined by using TPI, which can be easily obtained by examining the preoperative CT imaging, is an independent risk factor of severe postoperative complications. Determining the degree of sarcopenia can affect patient selection, predictability of possible serious complications, elective operation preparation process with a combination of nutrition and exercise therapy in a particular patient group and decisions regarding adjuvant or neoadjuvant therapy.

Does Cholecystectomy Prior to the Diagnosis of Pancreatic Cancer Affect Outcome?

2008 ◽  
Vol 74 (7) ◽  
pp. 602-606 ◽  
Author(s):  
Stephen H. Gray ◽  
Mary T. Hawn ◽  
Meredith L. Kilgore ◽  
Huifeng Yun ◽  
John D. Christein
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Early Diagnosis ◽  
Cancer Diagnosis ◽  
Curative Resection ◽  
Tumor Stage ◽  
Seer Database ◽  
Patient Demographics ◽  
Medicare Data

Early diagnosis and curative resection are significant predictors of survival in patients with pancreatic cancer. We hypothesize that cholecystectomy within 12 months of pancreatic cancer affects 1-year survival. The Surveillance Epidemiology and End Result (SEER) database linked to Medicare data was used to identify patients diagnosed with pancreatic cancer who underwent cholecystectomy 1 to 12 months prior to cancer diagnosis. The SEER database identified 32,569 patients from 1995 to 2002; 415 (1.3%) underwent cholecystectomy prior to cancer diagnosis. Patients who underwent cholecystectomy had a higher proportion of diabetes (40.2% vs 20.5%; P < 0.01), obesity (8.9% vs 3.1%; P < 0.01), jaundice (17.3% vs 0.7%; P < 0.01), cholelithiasis (70.4% vs 4.2%; P < 0.01), choledocholithiasis (0.7% vs 0.0%; P < 0.01), weight loss (17.3% vs 4.7%; P < 0.01), abdominal pain (79.5% vs 22.5%), steatorrhea (0.7% vs 0.0%; P < 0.01), and cholecystitis (32.3% vs 1.7%; P < 0.0001). After controlling for tumor stage, patient demographics, and symptoms, survival at 1 year was significantly lower in patients undergoing cholecystectomy (OR, 0.75; 95% CI, 0.58–0.97). Recent cholecystectomy is associated with decreased 1-year survival among patients with pancreatic cancer. For patients older than 65 years of age, further evaluation prior to cholecystectomy may be necessary to exclude pancreatic cancer, especially patients with jaundice, weight loss, and steatorrhea.

Impact of postoperative complications on pancreatic cancer survival and recurrence.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 446-446
Author(s):  
Masahiro Asari ◽  
Toru Aoyama ◽  
Yusuke Katayama ◽  
Masaaki Murakawa ◽  
Koichiro Yamaoku ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Cancer Survival ◽  
Disease Recurrence ◽  
Lymphatic Invasion ◽  
Curative Surgery ◽  
Independent Risk Factors ◽  
The Impact

446 Background: We investigated the impact of postoperative complications on pancreatic cancer survival and recurrence after curative surgery. Methods: This study included 164 patients who underwent curative surgery for pancreatic cancer between 2005 and 2014. The patients were classified into those with postoperative complications (C group) and those without postoperative complications (NC group). The risk factors for overall survival (OS) and recurrence-free survival (RFS) were identified. Results: Postoperative complications were found in 61 of the 164 patients (37.2%). The RFS rate at five years after surgery was 10.6% in the C group patients and was 21.0% in the NC group patients. The RFS tended to be worse in the C group than in the NC group (p=0.1756). The OS rate at five years after surgery was 7.4% in the C group and 22.8% in the NC group, which was significantly different (p=0.0189). The multivariate analysis demonstrated that postoperative complications and lymphatic invasion were significant independent risk factors for the RFS and OS. Conclusions: The development of postoperative complications was a risk factor for a decreased overall survival and for disease recurrence in patients who underwent curative surgery for pancreatic cancer. The surgical procedure, perioperative care and the surgical strategy should be carefully planned to avoid complications.

Sarcopenia is Associated with Perioperative Outcomes in Gastric Cancer Patients Undergoing Gastrectomy

2019 ◽  
Vol 75 (4) ◽  
pp. 213-222
Author(s):  
Bo Shi ◽  
Siyu Liu ◽  
Junqiang Chen ◽  
Jinlu Liu ◽  
Yihuan Luo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Univariate Analysis ◽  
Psoas Muscle ◽  
Perioperative Outcomes ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Nutrition Risk

Background: Sarcopenia is a syndrome in which skeletal muscle reduction is the main manifestation of age-related and/or disease-related malnutrition associated with postoperative complications and mortality. Objectives: The aim of the current study was to investigate the association between sarcopenia and postoperative complications as well as the nutrition risk of patients with gastric cancer (GC) who received gastrectomy. In addition, a comparative analysis was performed to evaluate the diagnostic accuracy of total psoas muscle area (TPA) and skeletal muscle area (SMA) in sarcopenia. Methods: Preoperative computed tomography scans were obtained from 279 GC patients who received a gastrectomy from June 2011 to May 2016. TPA and SMA at the level of the third lumbar vertebra (L3) were used as the sarcopenia diagnostic index. Patients were diagnosed with sarcopenia via the total psoas muscle index (TPI) and skeletal muscle index (SMI) methods. TPI and SMI were normalized with the square of the patient’s height (m2) by TPA and SMA. The Clavien-Dindo complications score system was used to classify the complication extent after gastrectomy. Univariate and multivariate logistic regression analyses were carried out to evaluate the risk factors for postoperative complications. Results: A total of 68 and 125 patients were diagnosed with sarcopenia by TPI and SMI, respectively. Eighty-eight (31.5%) patients experienced postoperative complications. Patients with sarcopenia also had a significantly extended postoperative stay (TPI-sarcopenia, 15.0 days vs. non-sarcopenia, 11.0 days, p < 0.001; and SMI-sarcopenia, 14.0 days vs. non-sarcopenia, 11.0 days, p < 0.001) and hospital stay (TPI-sarcopenia, 22.5 days vs. non-sarcopenia, 17.0 days, p < 0.001; and SMI-sarcopenia, 21.0 days vs. non-sarcopenia, 16.5 days, p < 0.001). Multivariate logistic analysis showed that both TPI-sarcopenia (OR 7.561, p < 0.001) and SMI-sarcopenia (OR 10.085, p < 0.001) were associated with the risk of postoperative complications. Furthermore, univariate analysis showed a high correlation between nutrition risk screening 2002 (NRS2002) and sarcopenia (p < 0.001). A total of 54 (79.4%) of the 68 patients who were classified as having sarcopenia by TPI and 94 (75.3%) of the 125 patients who were classified as having sarcopenia by SMI were diagnosed with nutritional risk. Conclusions: Sarcopenia is associated with the total length of hospital stay, postoperative hospital stay, and severe complications in GC patients undergoing gastrectomy. Moreover, SMI may be a more meaningful index than TPI in reducing the rate of misdiagnosis and in predicting adverse perioperative risk. In addition, sarcopenia may cause severe malnutrition and increases perioperative adverse risk. Thus, both sarcopenia and the NRS2002 nutritional score should be assessed during preoperative nutritional screening and evaluation for GC patients.

scholarly journals Psoas Muscle Index Defined by Computer Tomography Predicts the Presence of Postoperative Complications in Colorectal Cancer Surgery

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 472
Author(s):  
Zalán Benedek ◽  
Szabolcs Todor-Boér ◽  
Loránd Kocsis ◽  
Orsolya Bauer ◽  
Nicolae Suciu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Psoas Muscle ◽  
Albumin Level ◽  
Cancer Surgery ◽  
High Grade ◽  
C Reactive Protein ◽  
Muscle Area ◽  
Colorectal Cancer Surgery ◽  
Reactive Protein

Background and Objectives: Sarcopenia is a recognized prognostic factor for both complications and survival in cancer patients. This study aims to analyze the relationship between sarcopenia measured by psoas muscle index on computer tomography scans and the presence of postoperative complications in colorectal cancer surgery. Materials and Methods: In a prospective study we recorded data from 51 patients who underwent colorectal cancer surgery in the Mures County Clinical Hospital, Romania. Total psoas muscle area and psoas density were measured at the level of the third lumbal vertebra (L3) for further index calculation. We also evaluated the general characteristics and laboratory analyses to obtain more information about status of the patients. Short-term postoperative complications were scored according to the Clavien-Dindo classification. Results: The majority of the 51 patients were male (61%) and the median age was 65 years. More than half of the cancer was located in the rectum (56.9%), a quarter in the right colon (25.5%), the rest in the sigmoid (11.8%), and the left colon (5.9%). Twenty-one patients (41.2%) developed a complication, five (9.8%) of these were Clavien-Dindo grade 3, 4 or 5 (high grade) and sixteen (31.3%) grade 1 or 2 (low grade). The low- and high-grade groups showed a significantly lower right psoas muscle area, left psoas muscle area, total psoas muscle area, and psoas muscle index (p < 0.001 in all cases). Among laboratory analyses, a significantly lower perioperative hematocrit, hemoglobin, and albumin level were found in patients who developed complications. Furthermore we observed that an elevated serum C-reactive protein level was associated with a higher grade of complication (p < 0.043). Conclusions: The psoas muscle index (PMI) influence on the postoperative outcome is an important factor in our single center prospective study and it appears to be a good overall predictor in colorectal surgery. A lower PMI is directly associated with a low or high grade complication by Clavien-Dindo classification. Perioperative inflammatory and nutritional status evidenced by serum C-reactive protein (CRP) and albumin level influences the presence of postoperative complications.

scholarly journals Body Composition Assessment in Patients with Periampullary Neoplasma Undergoing Pancreaticoduodenetomy and its Predictive Value for Postoperative Complications

2021 ◽  
Author(s):  
Zhenghua Cai ◽  
Shanshan Xu ◽  
Yifan Zhang ◽  
Yifei Yang ◽  
Jian He ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Body Composition ◽  
Adipose Tissue ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Body Composition Assessment ◽  
Major Complications ◽  
Significant Difference ◽  
Preoperative Ct

Abstract BackgroundTo observe body composition parameters variance in patient with periampullary neoplasmas with different clinical characteristics and assess its predictive value for postoperative complications after pancreaticoduodenectomy. MethodsIn this study, we retrospectively reviewed the clinical and image data of 144 patients with periampullary neoplasmas.The area of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and total abdominal muscle area (TAMA) were measured from preoperative CT images at the 3rd lumbar vertebra level, the TAMA was normalized to stature and termed as skeleton muscle index (SMI). The perioperative and pathological data were collected. ResultsOf the included 144 patients, 80(55.6%), 29(20.1%) and 24(16.7%) patients were classified as sarcopenia, visceral obesity and sarcopenic obesity. 84(58.3%) patients were jaundiced and 28 (19.4%)，50 (34.7%)，66(45.8%) patients were diagnosed with benign pancreatic tumors, pancreatic cancer and non-pancreatic cancer respectively. The incidence rate of clinical postoperative pancreatic fistula(POPF) and other major complications were 38.2% and 16%.In the univariate analysis, jaundiced patients experienced more weight loss and had higher nutrition risk score, the TAMA[103.1(61.1-176.7) vs 111.8(74.1-198.2),P=0.021] and SMI(39.2±7.0 vs 42.6±9.1,P=0.012)were lower compared with non-jaundiced group. However, no significant difference were founded between different pathological results and it was not associated with occurrence of POPF and major complications.ConclusionJaundiced patients may experience more weight loss and have lower TAMA and SMI. Body morphometric analysis of preoperative CT did not show predictive value for postoperative complications and further multicenter studies are needed.Trail registrationRegistration number：2021-437-01.

A Low Total Psoas Muscle Area Index Is a Strong Prognostic Factor in Metastatic Pancreatic Cancer

Pancreas ◽  
2021 ◽  
Vol 50 (4) ◽  
pp. 579-586
Author(s):  
Nicolas Williet ◽  
Marion Fovet ◽  
Khawla Maoui ◽  
Clément Chevalier ◽  
Meriem Maoui ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Psoas Muscle ◽  
Metastatic Pancreatic Cancer ◽  
Muscle Area ◽  
Area Index
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