Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma
Abstract Background Preoperative sarcopenia is a predictor of poor survival in cancer patients. We hypothesized that sarcopenia could progress as occult metastasis arose, especially after highly invasive surgery for highly aggressive malignancy. This study aimed to evaluate the associations of posto...
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BMC
2022-12-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-10453-2 |
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| author | Sho Yasuta Motokazu Sugimoto Masashi Kudo Shin Kobayashi Shinichiro Takahashi Masaru Konishi Naoto Gotohda |
| author_facet | Sho Yasuta Motokazu Sugimoto Masashi Kudo Shin Kobayashi Shinichiro Takahashi Masaru Konishi Naoto Gotohda |
| author_sort | Sho Yasuta |
| collection | DOAJ |
| description | Abstract Background Preoperative sarcopenia is a predictor of poor survival in cancer patients. We hypothesized that sarcopenia could progress as occult metastasis arose, especially after highly invasive surgery for highly aggressive malignancy. This study aimed to evaluate the associations of postoperative changes in skeletal muscle mass volume with survival outcomes in patients who underwent surgery for perihilar cholangiocarcinoma. Methods Fifty-six patients who underwent major hepatectomy with extrahepatic bile duct resection for perihilar cholangiocarcinoma were studied. The skeletal muscle index (SMI) at the third lumbar vertebra was calculated from axial computed tomography images taken preoperatively and 3–6 months postoperatively (early postoperative period). The associations of clinicopathological variables, including changes of SMI after surgery, with overall survival and recurrence-free survival were evaluated. Moreover, the associations of decreased SMI and elevated serum carbohydrate antigen 19–9 level with early recurrence and poor survival was compared. Results Among 56 patients, 26 (46%) had sarcopenia preoperatively and SMI decreased in 29 (52%) in the early postoperative period. During the median follow-up of 57.9 months, 35 patients (63%) developed recurrence and 29 (50%) died. Decreased SMI in the early postoperative period was independently associated with a shorter overall survival (hazard ratio, 2.39; 95% confidence interval, 1.00–6.18; P = 0.049) and a shorter recurrence-free survival (hazard ratio, 2.14; 95% confidence interval, 1.04–4.57; P = 0.039), whereas elevated carbohydrate antigen 19–9 level was not. Conclusions Decreased SMI in the early postoperative period may be used as a predictor for recurrence and poor survival in patients undergoing surgery for perihilar cholangiocarcinoma. |
| first_indexed | 2024-04-11T04:06:46Z |
| format | Article |
| id | doaj.art-d8410bc920674cf1b64a3c9bdfb46377 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-11T04:06:46Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-d8410bc920674cf1b64a3c9bdfb463772023-01-01T12:21:23ZengBMCBMC Cancer1471-24072022-12-0122111010.1186/s12885-022-10453-2Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinomaSho Yasuta0Motokazu Sugimoto1Masashi Kudo2Shin Kobayashi3Shinichiro Takahashi4Masaru Konishi5Naoto Gotohda6Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastDepartment of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastDepartment of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastDepartment of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastDepartment of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastDepartment of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastDepartment of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital EastAbstract Background Preoperative sarcopenia is a predictor of poor survival in cancer patients. We hypothesized that sarcopenia could progress as occult metastasis arose, especially after highly invasive surgery for highly aggressive malignancy. This study aimed to evaluate the associations of postoperative changes in skeletal muscle mass volume with survival outcomes in patients who underwent surgery for perihilar cholangiocarcinoma. Methods Fifty-six patients who underwent major hepatectomy with extrahepatic bile duct resection for perihilar cholangiocarcinoma were studied. The skeletal muscle index (SMI) at the third lumbar vertebra was calculated from axial computed tomography images taken preoperatively and 3–6 months postoperatively (early postoperative period). The associations of clinicopathological variables, including changes of SMI after surgery, with overall survival and recurrence-free survival were evaluated. Moreover, the associations of decreased SMI and elevated serum carbohydrate antigen 19–9 level with early recurrence and poor survival was compared. Results Among 56 patients, 26 (46%) had sarcopenia preoperatively and SMI decreased in 29 (52%) in the early postoperative period. During the median follow-up of 57.9 months, 35 patients (63%) developed recurrence and 29 (50%) died. Decreased SMI in the early postoperative period was independently associated with a shorter overall survival (hazard ratio, 2.39; 95% confidence interval, 1.00–6.18; P = 0.049) and a shorter recurrence-free survival (hazard ratio, 2.14; 95% confidence interval, 1.04–4.57; P = 0.039), whereas elevated carbohydrate antigen 19–9 level was not. Conclusions Decreased SMI in the early postoperative period may be used as a predictor for recurrence and poor survival in patients undergoing surgery for perihilar cholangiocarcinoma.https://doi.org/10.1186/s12885-022-10453-2SarcopeniaPerihilar cholangiocarcinomaMajor hepatectomySkeletal muscle mass volumeSurvival outcomes |
| spellingShingle | Sho Yasuta Motokazu Sugimoto Masashi Kudo Shin Kobayashi Shinichiro Takahashi Masaru Konishi Naoto Gotohda Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma BMC Cancer Sarcopenia Perihilar cholangiocarcinoma Major hepatectomy Skeletal muscle mass volume Survival outcomes |
| title | Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma |
| title_full | Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma |
| title_fullStr | Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma |
| title_full_unstemmed | Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma |
| title_short | Early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma |
| title_sort | early postoperative decrease of skeletal muscle mass predicts recurrence and poor survival after surgical resection for perihilar cholangiocarcinoma |
| topic | Sarcopenia Perihilar cholangiocarcinoma Major hepatectomy Skeletal muscle mass volume Survival outcomes |
| url | https://doi.org/10.1186/s12885-022-10453-2 |
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