Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis
The burden of post-operative complications of patients undergoing liver resection for hepatocellular carcinoma (HCC) is a cause of morbidity and mortality. Recently, sarcopenia has been reported to influence the outcome of patients with cirrhosis. We aimed to assess factors associated with sarcopeni...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/8/1935 |
| _version_ | 1797436559485566976 |
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| author | Giovanni Marasco Elton Dajti Matteo Serenari Luigina Vanessa Alemanni Federico Ravaioli Matteo Ravaioli Amanda Vestito Giulio Vara Davide Festi Rita Golfieri Matteo Cescon Matteo Renzulli Antonio Colecchia |
| author_facet | Giovanni Marasco Elton Dajti Matteo Serenari Luigina Vanessa Alemanni Federico Ravaioli Matteo Ravaioli Amanda Vestito Giulio Vara Davide Festi Rita Golfieri Matteo Cescon Matteo Renzulli Antonio Colecchia |
| author_sort | Giovanni Marasco |
| collection | DOAJ |
| description | The burden of post-operative complications of patients undergoing liver resection for hepatocellular carcinoma (HCC) is a cause of morbidity and mortality. Recently, sarcopenia has been reported to influence the outcome of patients with cirrhosis. We aimed to assess factors associated with sarcopenia and its prognostic role in liver surgery candidates. We included all patients with compensated advanced chronic liver disease (cACLD) undergoing liver resection for primary HCC consecutively referred to the University of Bologna from 2014 to 2019 with an available preoperative abdominal CT-scan performed within the previous three months. A total of 159 patients were included. The median age was 68 years, and 80.5% of the patients were male. Sarcopenia was present in 82 patients (51.6%). Age and body mass index (BMI) were associated with the presence of sarcopenia at multivariate analysis. Thirteen (8.2%) patients developed major complications and 14 (8.9%) presented PHLF grade B-C. The model for end-stage liver disease score was associated with the development of major complications, whereas cACLD presence, thrombocytopenia, portal hypertension (PH), Child-Pugh score and Albumin-Bilirubin score were found to be predictors of clinically significative PHLF. The rate of major complications was 11.8% in sarcopenic patients with cACLD compared with no complications (0%) in patients without sarcopenia and cACLD (<i>p</i> = 0.032). The rate of major complications was significantly higher in patients with (16.3%) vs. patients without (0%) sarcopenia (<i>p</i> = 0.012) in patients with PH. In conclusion, sarcopenia, which is associated with age and BMI, may improve the risk stratification of post-hepatectomy major complications in patients with cACLD and PH. |
| first_indexed | 2024-03-09T11:03:28Z |
| format | Article |
| id | doaj.art-9e3c1d3492c74d709da59495699614d1 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T11:03:28Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9e3c1d3492c74d709da59495699614d12023-12-01T01:06:13ZengMDPI AGCancers2072-66942022-04-01148193510.3390/cancers14081935Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated CirrhosisGiovanni Marasco0Elton Dajti1Matteo Serenari2Luigina Vanessa Alemanni3Federico Ravaioli4Matteo Ravaioli5Amanda Vestito6Giulio Vara7Davide Festi8Rita Golfieri9Matteo Cescon10Matteo Renzulli11Antonio Colecchia12Internal Medicine and Digestive Pathophysiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyGastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyRadiology Division, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyRadiology Division, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyRadiology Division, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyGastroenterology Unit, University Hospital of Modena, 41125 Modena, ItalyThe burden of post-operative complications of patients undergoing liver resection for hepatocellular carcinoma (HCC) is a cause of morbidity and mortality. Recently, sarcopenia has been reported to influence the outcome of patients with cirrhosis. We aimed to assess factors associated with sarcopenia and its prognostic role in liver surgery candidates. We included all patients with compensated advanced chronic liver disease (cACLD) undergoing liver resection for primary HCC consecutively referred to the University of Bologna from 2014 to 2019 with an available preoperative abdominal CT-scan performed within the previous three months. A total of 159 patients were included. The median age was 68 years, and 80.5% of the patients were male. Sarcopenia was present in 82 patients (51.6%). Age and body mass index (BMI) were associated with the presence of sarcopenia at multivariate analysis. Thirteen (8.2%) patients developed major complications and 14 (8.9%) presented PHLF grade B-C. The model for end-stage liver disease score was associated with the development of major complications, whereas cACLD presence, thrombocytopenia, portal hypertension (PH), Child-Pugh score and Albumin-Bilirubin score were found to be predictors of clinically significative PHLF. The rate of major complications was 11.8% in sarcopenic patients with cACLD compared with no complications (0%) in patients without sarcopenia and cACLD (<i>p</i> = 0.032). The rate of major complications was significantly higher in patients with (16.3%) vs. patients without (0%) sarcopenia (<i>p</i> = 0.012) in patients with PH. In conclusion, sarcopenia, which is associated with age and BMI, may improve the risk stratification of post-hepatectomy major complications in patients with cACLD and PH.https://www.mdpi.com/2072-6694/14/8/1935post-hepatectomy liver failureliver resectionhepatocellular carcinomasarcopenia |
| spellingShingle | Giovanni Marasco Elton Dajti Matteo Serenari Luigina Vanessa Alemanni Federico Ravaioli Matteo Ravaioli Amanda Vestito Giulio Vara Davide Festi Rita Golfieri Matteo Cescon Matteo Renzulli Antonio Colecchia Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis Cancers post-hepatectomy liver failure liver resection hepatocellular carcinoma sarcopenia |
| title | Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis |
| title_full | Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis |
| title_fullStr | Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis |
| title_full_unstemmed | Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis |
| title_short | Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis |
| title_sort | sarcopenia predicts major complications after resection for primary hepatocellular carcinoma in compensated cirrhosis |
| topic | post-hepatectomy liver failure liver resection hepatocellular carcinoma sarcopenia |
| url | https://www.mdpi.com/2072-6694/14/8/1935 |
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