Association between CT-Based Preoperative Sarcopenia and Outcomes in Patients That Underwent Liver Resections

Martín, David; Maeder, Yaël; Kobayashi, Kosuke; Schneider, Michael; Koerfer, Joachim; Melloul, Emmanuel; Halkic, Nermin; Demartines, Nicolas; Becce, Fabio; Uldry, Émilie

doi:10.3390/cancers14010261

Cited by 13 publications

(15 citation statements)

References 65 publications

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“…Indications to surgery consisted in CRLM (43.7%), HCC (13.2%), CCA (15.5%); 10% of the patients underwent surgery for non-oncological indications. The authors concluded that other items like muscle strength and physical performance, in addition to imaging, should be considered for preoperative risk stratification ( 17 ).…”

Section: Resultsmentioning

confidence: 99%

“…Lastly, whether a minimally invasive approach (MILS) for oncologic liver resection could reduce the impact of an unfavorable body composition profile by reducing for example abdominal wall trauma has not been specifically addressed. The rate of MILS adoption in the studies included is scarcely reported (seven out of 33 articles included) and subgroup outcomes have been reported in only two studies without significant findings ( 16 , 17 ). This indeed would represent an interesting field of research.…”

Section: Discussionmentioning

confidence: 98%

“…Three articles investigated the impact of body composition on the outcome after liver surgery irrespective of the indication for hepatic resection. All authors used sarcopenia as a comparator and specifically focused on the short-term results of liver resection (15)(16)(17). (Supplementary material, Tab.S1)…”

Section: Liver Resection Irrespective Of Indicationmentioning

confidence: 99%

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Imaging based body composition profiling and outcomes after oncologic liver surgery

et al. 2022

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Body composition profiling is gaining attention as a pre-operative factor that can play a role in predicting the short- and long- term outcomes of patients undergoing oncologic liver surgery. Existing evidence is mostly limited to retrospective and single-institution series and in many of these studies, the evaluation of body composition is based on parameters which are derived from CT-scan imaging. Among body composition phenotypes, sarcopenia is the most well studied but this is only one of the possible profiles which can impact the outcomes of oncologic hepatic surgery. Interest has recently grown in studying the effect of sarcopenic obesity, central obesity, or visceral fat amount, myosteatosis, and bone mineral density on -such patients. The objective of this review is to summarize the current evidence on whether imaging-based parameters of body composition have an impact on the outcome of patients undergoing liver surgery for each of the most frequent indications for liver resection in clinical practice: hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), and colorectal liver metastases (CRLM).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

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Imaging based body composition profiling and outcomes after oncologic liver surgery

et al. 2022

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“…While there are only a few publications dealing with sarcopenia as a predictor of kidney graft outcome [5,16,19,20,30,31], a large number of studies published in the last years show an increased postoperative morbidity and mortality after visceral surgery and in oncologic patients [37][38][39][40][41][42][43]. A meta-analysis explored independent risk factors for [45].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Karakizlis

Trudel

Brose

et al. 2023

Langenbecks Arch Surg

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Purpose The association between sarcopenia of kidney transplant recipients and outcome after kidney transplantation (KT) has not yet been fully understood and is still considered controversial. The aim of our study was to analyze the impact of pre-transplant sarcopenia on graft function, postoperative complication rates, and survival of the patients after renal transplantation. Methods In this retrospective single-center study, all patients who underwent KT (01/2013–12/2017) were included. Demographic data, rejection rates, delayed graft function, and graft and patient survival rates were analyzed. Sarcopenia was measured in computed tomography images by the sex-adjusted Hounsfield unit average calculation (HUAC). Results During the study period, 111 single KTs (38 women and 73 men) were performed. Living donor kidney transplants were performed in 48.6%. In total, 32.4% patients had sarcopenia. Sarcopenic patients were significantly older (59.6 years vs. 49.8 years; p < 0.001), had a higher body mass index (BMI = 27.6 kg/m2 vs. 25.0 kg/m2; p = 0.002), and were more likely to receive deceased donor kidneys (72.2% vs. 41.3%; p = 0.002). Interestingly, 3 years after KT, the creatinine serum levels were significantly higher (2.0 mg/dl vs. 1.5 mg/dl; p = 0.001), whereas eGFR (39.9 ml/min vs. 53.4 ml/min; p = 0.001) and graft survival were significantly lower (p = 0.004) in sarcopenic transplant recipients. Sarcopenic patients stayed in hospital significantly longer postoperatively than those who were non-sarcopenic. Conclusions At the time of kidney transplantation, sarcopenia was found to predict reduced long-term graft function and diminished graft survival after KT. The early identification of sarcopenic patients can not only enable an optimized selection of recipients, but also the initiation of pre-habilitation programs during the waiting period.

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“…The impact of sarcopenia did not differ significantly between primary hepatic malignancies and metastases. Of the studies combining different malignancies [30,32,49], two did not refer to SMI as a measure of sarcopenia alone, but Berardi et al used the combination of reduced muscle mass and strength as a definition of LSMM, while Valero et al applied TPA and TPV. Our overall results exhibit a somewhat lower OR for post-operative complications for liver resection than those published for gastrectomy or surgery for CRC [13,14].…”

Section: Discussionmentioning

confidence: 99%

Low skeletal muscle mass and post-operative complications after surgery for liver malignancies: a meta-analysis

Thormann

Omari

Pech

et al. 2022

Langenbecks Arch Surg

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Purpose To assess the influence of low skeletal muscle mass (LSMM) on post-operative complications in patients with hepatic malignancies grade (Clavien Dindo ≥ 3) undergoing resection. Methods MEDLINE, Cochrane, and SCOPUS databases were screened for associations between sarcopenia and major post-operative complications (≥ grade 3 according to Clavien-Dindo classification) after resection of different malignant liver tumors. RevMan 5.3 software was used to perform the meta-analysis. The methodological quality of the included studies was assessed according to the QUIPS instrument. Results The analysis included 17 studies comprising 3157 patients. Subgroup analyses were performed for cholangiocarcinoma (CCC), colorectal cancer (CRC) liver metastases, and hepatocellular carcinoma (HCC). LSMM as identified on CT was present in 1260 patients (39.9%). Analysis of the overall sample showed that LSMM was associated with higher post-operative complications grade Clavien Dindo ≥ 3 (OR 1.56, 95% CI 1.25–1.95, p < 0.001). In the subgroup analysis, LSMM was associated with post-operative complications in CRC metastases (OR 1.60, 95% CI 1.11–2.32, p = 0.01). In HCC and CCC sub-analyses, LSMM was not associated with post-operative complications in simple regression analysis. Conclusion LSMM is associated with major post-operative complications in patients undergoing surgery for hepatic metastases and it does not influence major post-operative complications in patients with HCC and CCC.

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Association between CT-Based Preoperative Sarcopenia and Outcomes in Patients That Underwent Liver Resections

Cited by 13 publications

References 65 publications

Imaging based body composition profiling and outcomes after oncologic liver surgery

Imaging based body composition profiling and outcomes after oncologic liver surgery

Sarcopenia of kidney transplant recipients as a predictive marker for reduced graft function and graft survival after kidney transplantation

Low skeletal muscle mass and post-operative complications after surgery for liver malignancies: a meta-analysis

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