Sarcopenia as a factor of prognosis for development of postoperative complications in patients with pancreatic adenocarcinoma
Objective. Determination of sarcopenia impact on occurrence of complications after pancreatic resections for the organ’s malignancies.
Маterials and methods. There were retrospectively analyzed the treatment results in 87 patients, in whom radical operations were performed. Using preoperative CT, the average value of density was calculated in Hounsfield Units (Hounsfield Unit Average Calculation - HUAC), and a summated Total Psoas Index (TPI) of m. psoas major on the level of the third lumbar vertebra.
Results. In 35 (40.2%) patients a sarcopenia was revealed while applying HUAC index. Postoperative complications have occurred in 21 (60%) patients with sarcopenia, 2 (5.7%) patients died. Postoperative complications have occurred in 16 (30.8%) patients without sarcopenia, 1 (1.9%) patient died. Using a TPI, a sarcopenia was diagnosed in 38 (43.7%) patients, of them the complications have had occurred in 21 (55.3%), and 2 (5.3%) died. Complications have occurred in у 16 (32.6%) patients without sarcopenia, 1 (2.0%) patient died.
Conclusion. Sarcopenia trustworthily impacts the postoperative complications rate, its revealing may be applied for improvement of the patients’ selection before conduction of pancreatic resection for the organ’s malignancies.
2. Hartwig W, Gluth A, Hinz U, Koliogiannis D, Strobel O, Hackert T, et al. Outcomes after extended pancreatectomy in patients with borderline resectable and locally advanced pancreatic cancer. Br J Surg. 2016 Nov;103(12):1683-94. doi: 10.1002/bjs.10221.
3. Kaiser J, Hackert T, Buchler MW. Extended pancreatectomy: does it have a role in the contemporary management of pancreatic adenocarcinoma? Dig Surg. 2017 July 13;34:441-6. doi: 10.1159/000478539.
4. He J, Page AJ, Weiss M, Wolfgang CL, Herman JM, Pawlik TM. Management of borderline and locally advanced pancreatic cancer: where do we stand? World J Gastroenterol 2014; March 7; 20(9): 2255-66. doi: 10.3748/wjg.v20.i9.2255
5. Kim TN, Choi KM. Sarcopenia. Definition, epidemiology, and pathophysiology. J Bone Metab. 2013;20:1-10. http://dx.doi.org/10.11005/jbm.2013.20.1.1
6. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and Ageing. 2010; 39:412-23. doi:10.1093/ageing/afq034.
7. Joglekar S, Asghar A, Mott SL, Johnson BE, Button AM, et al. Sarcopenia is an independent predictor of complications following pancreatectomy for adenocarcinoma. Iowa J Surg Oncol. 2015 May;111(6):771-5. doi:10.1002/jso.23862.
8. Peng P, Hyder O, Firoozmand A, Kneuertz P, Schulick RD, Huang D, et. al. Impact of sarcopenia on outcomes following resection of pancreatic adenocarcinoma. J Gastrointest Surg. 2012 August;16(8):1478-86. doi:10.1007/s11605-012-1923-5.
9. Amini N, Spolverato G, Gupta R, Margonis GA, Kim Y, Wegner D, et al. Impact of total psoas volume on short - and long- term outcomes in patients undergoing curative resection for pancreatic adenocarcinoma: a new tool to assess sarcopenia. J Gastrointest Surg. 2015 September;19(9):1593-602. doi:10.1007/s11605-015-2835-y.
10. Namm JP, Thakrar KH, Wang CH, Stocker SJ, Sur MD, Berlin J, Dale W, et al. A semi-automated assessment of sarcopenia using psoas area and density predicts outcomes after pancreaticoduodenectomy - for pancreatic malignancy. J Gastrointest Oncol, 2017;8(6):936-44. doi: 10.21037/jgo.2017.08.09.
11. Takagi K, Yoshida R, Yagi T, Umeda Y, Nobuoka D, Kuise T, Fujiwara T. Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy. BMC Surgery. 2017;17:64.
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