Sarcopenia negatively affects postoperative short-term outcomes of patients with non-cirrhosis liver cancer

被引:5
作者
Yang, Jinhuan [1 ]
Wang, Daojie [1 ]
Ma, Lei [2 ]
An, Xuewen [2 ]
Hu, Zijing [3 ]
Zhu, Huili [4 ]
Zhang, Wanqian [2 ]
Chen, Kaiwen [1 ]
Ma, Jun [5 ]
Yang, Yan [5 ]
Wu, Lijun [1 ]
Chen, Gang [1 ,6 ]
Wang, Yi [5 ]
机构
[1] Wenzhou Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 1, Wenzhou 325035, Zhejiang, Peoples R China
[2] Wenzhou Med Univ, Sch Lab Med & Life Sci, Wenzhou, Zhejiang, Peoples R China
[3] Wenzhou Med Univ, Sch Nursing, Wenzhou, Zhejiang, Peoples R China
[4] Wenzhou Med Univ, Sch Med 1, Sch Informat & Engn, Wenzhou, Zhejiang, Peoples R China
[5] Wenzhou Med Univ, Sch Publ Hlth & Management, Dept Epidemiol & Biostat, Chashan High Educ Zone, Wenzhou 325035, Zhejiang, Peoples R China
[6] Wenzhou Med Univ, Key Lab Diag & Treatment Severe Hepatopancreat Dis, Affiliated Hosp 1, Wenzhou 325035, Zhejiang, Peoples R China
基金
中国国家自然科学基金;
关键词
Sarcopenia; Non-cirrhosis; Liver cancer; Muscle strength; Short-term outcomes; HEPATOCELLULAR-CARCINOMA; RESECTION; RISK; TRANSPLANTATION; METAANALYSIS; ASSOCIATION; FRAILTY; MODEL;
D O I
10.1186/s12885-023-10643-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Literature review have shown that sarcopenia substantially alters the postoperative outcomes after liver resection for malignant tumors. However, these retrospective studies do not distinguish cirrhotic and non-cirrhotic liver cancer patients, nor combine the assessment of muscle strength in addition to muscle mass. The purpose of this study is to study the relationship between sarcopenia and short-term outcomes after hepatectomy in patients with non-cirrhotic liver cancer. Methods From December 2020 to October 2021, 431 consecutive inpatients were prospectively enrolled in this study. Muscle strength and mass were assessed by handgrip strength and the skeletal muscle index (SMI) on preoperative computed tomographic scans, respectively. Based on the SMI and the handgrip strength, patients were divided into four groups: group A (low muscle mass and strength), group B (low muscle mass and normal muscle strength), group C (low muscle strength and normal muscle mass), and group D (normal muscle mass and strength). The main outcome was major complications and the secondary outcome was 90-d Readmission rate. Results After strictly exclusion, 171 non-cirrhosis patients (median age, 59.00 [IQR, 50.00-67.00] years; 72 females [42.1%]) were selected in the final analysis. Patients in group A had a statistically significantly higher incidence of major postoperative complications (Clavien-Dindo classification >= III) (26.1%, p = 0.032), blood transfusion rate (65.2%, p < 0.001), 90-day readmission rate (21.7%, p = 0.037) and hospitalization expenses (60,842.00 [IQR, 35,563.10-87,575.30], p < 0.001) than other groups. Sarcopenia (hazard ratio, 4.21; 95% CI, 1.44-9.48; p = 0.025) and open approach (hazard ratio, 2.56; 95% CI, 1.01-6.49; p = 0.004) were independent risk factors associated with major postoperative complications. Conclusions Sarcopenia is closely related to poor short-term postoperative outcomes in non-cirrhosis liver cancer patients and the assessment that combines muscle strength and muscle mass can simply and comprehensively identify it.
引用
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页数:10
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