Adverse Effects of Low Preoperative Skeletal Muscle Mass in Patients Undergoing Gastrectomy for Gastric Cancer

Sakurai, Katsunobu; Kubo, Naoshi; Tajiri, Tatsuro; Toyokawa, Takahiro; Amano, Ryosuke; Tanaka, Hiroaki; Muguruma, Kazuya; Yashiro, Masakazu; Maeda, Kiyoshi; Hirakawa, Kosei; Ohira, Masaichi

doi:10.1245/s10434-017-5875-6

Cited by 86 publications

(90 citation statements)

References 20 publications

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“…The association between low muscle mass and postoperative complications was reported in 12 studies [12,13,[23][24][25][26][27][28][29][30][31][32] of which 9 studies reported data on severe postoperative complications (Clavien-Dindo grade ≥III) [12,[23][24][25][26][27][28]31,32]. Overall mortality was reported as an outcome measure in 9 studies [24][25][26]28,31,[33][34][35], and 5 studies reported on disease-specific mortality [28,31,[33][34][35].…”

Section: Study Selectionmentioning

confidence: 99%

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

Borggreve

Boer

Boxel

et al. 2020

JCM

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Risk assessment is relevant to predict outcomes in patients with gastric cancer. This systematic review aimed to investigate the predictive value of low muscle mass for postoperative complications in gastric cancer patients. A systematic literature search was performed to identify all articles reporting on muscle mass as measured on computed tomography (CT) scans in patients with gastric cancer. After full text screening, 15 articles reporting on 4887 patients were included. Meta-analysis demonstrated that patients with low muscle mass had significantly higher odds of postoperative complications (odds ratio (OR): 2.09, 95% confidence interval (CI): 1.55–2.83) and severe postoperative complications (Clavien–Dindo grade ≥III, OR: 1.73, 95% CI: 1.14–2.63). Moreover, patients with low muscle mass had a significantly higher overall mortality (hazard ratio (HR): 1.81, 95% CI: 1.52–2.14) and disease-specific mortality (HR: 1.58, 95% CI: 1.36–1.84). In conclusion, assessment of muscle mass on CT scans is a potential relevant clinical tool for risk prediction in gastric cancer patients. Considering the heterogeneity in definitions applied for low muscle mass on CT scans in the included studies, a universal cutoff value of CT-based low muscle mass is required for more reliable conclusions.

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Section: Study Selectionmentioning

confidence: 99%

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

Borggreve

Boer

Boxel

et al. 2020

JCM

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“…Generally, most studies reported an increased risk of postoperative morbidity with ORs of 3 to 9 27,28. However, such observations were not uniform, with some studies showing no effects on postoperative outcomes13,29,30 or impaired recovery only for subgroups i.e. severe sarcopenia 28 or sarcopenic obesity.…”

mentioning

confidence: 99%

Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach

Sierżęga

Chrzan

Wiktorowicz

et al. 2019

Journal of Surgical Oncology

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Introduction Sarcopenia is highly prevalent in patients with gastrointestinal malignancies, including gastric cancer, but there is a lack of adequate data from Western populations. Methods Computed tomography scans of 138 Caucasian patients subject to stomach resections due to gastric adenocarcinoma between 2012 and 2015 were reviewed to evaluate the impact of sarcopenia. The definition of sarcopenia was based on the lumbar skeletal muscle index (SMI) using cut‐off values formulated by the international consensus definitions of sarcopenia (SMI <52.4 cm2/m2 for men and <38.5 cm2/m2 for women). Results Sixty (43%) of 138 patients were sarcopenic. Sarcopenia was associated with postoperative morbidity (43% vs 23%; P = .011), major postoperative complications (Clavien‐Dindo ≥3a; 36% vs 21%; P = .035), and reoperations (23% vs 9%; P = .020). Patients with sarcopenia also had prolonged postoperative hospital stay (8.0 vs 6.5 days; P = .010). The overall median survival of patients with sarcopenia was significantly lower than those with normal skeletal muscles (11.0 vs 36.7 months; P = .005) and sarcopenia remained an independent prognostic factor with an odds ratio of 1.94 (95% confidence interval, 1.08 to 3.48; P = .026). Conclusion Sarcopenia, defined by SMI, is associated with an increased risk of postoperative morbidity and impaired long‐term survival.

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“…The skeletal muscle mass was normalized by height in meters squared as the skeletal muscle index (SMI, cm 2 /m 2 ). Using the volume analyzer SYNAPSE VINCENT (Fujifilm, Tokyo, Japan), differential tissue areas were calculated in Hounsfield units (HU) . The skeletal muscle mass was evaluated within an HU range of −20 to 100 HU that was modified in a previous report to exclude vasculature and areas of fatty infiltration .…”

Section: Methodsmentioning

confidence: 99%

“…Using the volume analyzer SYNAPSE VINCENT (Fujifilm, Tokyo, Japan), differential tissue areas were calculated in Hounsfield units (HU). 22 The skeletal muscle mass was evaluated within an HU range of −20 to 100 HU 23 that was modified in a previous report to exclude vasculature and areas of fatty infiltration. 24,25 The VFA and SFA were calculated within an HU range of −200 to −50 HU.…”

Section: Methodsmentioning

confidence: 99%

Skeletal muscle mass is associated with toxicity, treatment tolerability, and additional or subsequent therapies in patients with hepatocellular carcinoma receiving sorafenib treatment

et al. 2019

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Background and Aim Several reports have demonstrated that skeletal muscle mass influences mortality in patients with hepatocellular carcinoma (HCC) receiving sorafenib treatment; however, there is still controversy with regard to whether skeletal muscle and adipose tissue are associated with the prognosis in HCC patients. We examined the relationship between body composition and prognosis in HCC patients. Methods We retrospectively analyzed 82 patients with unresectable HCC receiving sorafenib treatment. The skeletal muscle area and adipose tissue area were measured by computed tomography. Patients with low skeletal muscle index (male ≤36.2 cm 2 /m 2 , female ≤29.6 cm 2 /m 2 ) and high visceral to subcutaneous adipose tissue area ratio (VSR) (male ≥ 1.33, female ≥ 0.93) were diagnosed as low skeletal muscle mass (LSMM) and high VSR, respectively. Results A total of 16 and 34 patients were classified as LSMM and high VSR, respectively. LSMM patients frequently experienced serious adverse events (SAEs) and thus had a shorter duration of sorafenib treatment than non‐LSMM patients. High VSR was a significant factor for progression‐free survival. LSMM patients less frequently received additional/subsequent therapies combined with sorafenib than non‐LSMM patients. Multivariate Cox hazard analysis demonstrated that LSMM was a significant factor for the duration of sorafenib treatment. The treatment duration and receiving of additional/subsequent therapies were significantly associated with overall survival (OS) but not with LSMM or high VSR. Conclusion LSMM was associated with the frequency of SAEs, treatment tolerability, and treatment duration. LSMM patients were less likely to receive additional/subsequent therapies than non‐LSMM patients. Thus, LSMM could identify a subgroup of patients with poor OS.

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Adverse Effects of Low Preoperative Skeletal Muscle Mass in Patients Undergoing Gastrectomy for Gastric Cancer

Cited by 86 publications

References 20 publications

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

Prognostic and predictive implications of sarcopenia in Western patients undergoing gastric resections for carcinoma of the stomach

Skeletal muscle mass is associated with toxicity, treatment tolerability, and additional or subsequent therapies in patients with hepatocellular carcinoma receiving sorafenib treatment

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