Association between low preoperative skeletal muscle quality and infectious complications following gastrectomy for gastric cancer

Uchida, Tsuneyuki; Sekine, Ryuichi; Matsuo, Keitaro; Kigawa, Gaku; Umemoto, Takuya; Kijima, Kazuhiro; Harada, Yoshikuni; Wakabayashi, T.; Takahashi, Yuki; Shiozawa, Toshimitsu; Oyama, Hideyuki; Shibata, Shiori; Tanaka, Kuniya

doi:10.1007/s00595-020-02225-x

Cited by 7 publications

(6 citation statements)

References 51 publications

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“…CT scans were obtained and evaluated for body composition data by two government‐certified physical therapists blinded to the patients' information under the guidance of a diagnostic radiologist. A high intramuscular adipose tissue content was considered to represent low muscle quality 28 . We evaluated the correlation between IMAT evaluated by entire muscle cross sections and IMAT evaluated by four ROIs in 20 cases of our study.…”

Section: Methodsmentioning

confidence: 99%

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High intramuscular adipose tissue content was a favorable prognostic factor in patients with advanced gastric cancer treated with nivolumab monotherapy

Tanaka,

Miwa,

Shimotsuura

et al. 2023

J of Gastro and Hepatol

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BackgroundNivolumab extends the overall survival (OS) of patients with advanced gastric cancer (AGC). Intramuscular adipose tissue (IMAT) is associated with the prognosis of patients with various cancers. We investigated the effect of IMAT on OS in patients with AGC treated with nivolumab.MethodsWe enrolled patients with AGC treated with nivolumab (n = 58, 67 years old, men/women 40/18). The subjects were classified into long‐term or short‐term survival groups according to the median value. The IMAT was evaluated using computed tomography scans at the umbilical level. The decision tree algorithm was employed to reveal the profile associated with prognosis.ResultsIn decision tree analysis, immune‐related adverse events (irAEs) were the first divergence variable, and prolonged survival was observed in 100% of patients with irAEs (profile 1). However, long survival was observed in 38% of patients with no irAEs. Among these patients, IMAT was identified as the second divergence variable, and long survival was observed in 63% of patients with high IMAT (profile 2). In patients with low IMAT, only 21% showed prolonged survival (profile 3). Median OS was 717 days (95% confidence interval [CI], 223 to not reached) in profile 1, 245 days (95% CI, 126 to 252) in profile 2, and 132 days (95% CI, 69 to 163) in profile 3.ConclusionImmune‐related adverse events and high IMAT were favorable factors for OS in patients with AGC treated with nivolumab. Thus, along with irAEs, skeletal muscle quality is important in managing patients with AGC treated with nivolumab.

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Section: Methodsmentioning

confidence: 99%

“…A high intramuscular adipose tissue content was considered to represent low muscle quality. 28 We evaluated the correlation between IMAT evaluated by entire muscle cross sections and IMAT evaluated by four ROIs in 20 cases of our study.…”

Section: Biochemicalmentioning

confidence: 99%

High intramuscular adipose tissue content was a favorable prognostic factor in patients with advanced gastric cancer treated with nivolumab monotherapy

Tanaka,

Miwa,

Shimotsuura

et al. 2023

J of Gastro and Hepatol

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“…For muscle quality, CT values (HU) of regions of interest were measured at the umbilical level. We then calculated the intramuscular adipose tissue content (IMAC) by dividing the CT value of the multifidus muscles with that of subcutaneous fat, as presented in previous studies [ 19 , 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, we also evaluated the previously reported cut-off values for HGS, SMI, and IMAC to diagnose sarcopenia in patients with gastric cancer. The cut-off values used in this study are shown in Table 1 [ 9 , 15 , 17 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of Preoperative Handgrip Strength on Postoperative Outcome after Radical Gastrectomy for Gastric Cancer Patients

Matsui

Inaki

Tsuji

et al. 2022

JCM

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In this study, we investigated whether preoperative low-handgrip strength (HGS) defined by the Asian working group for sarcopenia could be a predictor of postoperative outcomes in patients with gastric cancer. A total of 327 patients who underwent radical gastrectomy for c-stage I–III primary gastric cancer with pre-operative HGS records were included. The cut-off values of HGS were defined as 28 kg for males and 18 kg for females, with values below and above the cut-off defined as low-HGS and high-HGS, respectively. The primary outcome was infectious complications. We compared the postoperative outcomes of the groups after adjusting for the background using propensity score matching. Of the 327 patients, 246 (75.2%) and 81 (24.8%) were in the high and low-HGS groups, respectively. After adjusting for background, there were 57 patients in both groups. After matching, the low-HGS group had significantly more infectious complications (17.5% vs. 1.8%, p = 0.008). Multivariate analysis of infectious complications in the low-HGS group demonstrated chronic kidney disease and diabetes as independent risk factors (odds ratio 4.390, 95% confidence interval 1.120–17.20, p = 0.034). Preoperative low-HGS according to the Asian criteria was associated with infectious complications after gastrectomy. Chronic kidney disease and diabetes were independent risk factors for infectious complications among patients with low-HGS.

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“…Evidence suggests that the presence of low skeletal muscle mass negatively affects outcomes in elective surgical procedures [31]. After surgery, the rate of sarcopenia may increase and studies have shown that more than half of patients have low muscle mass and/ or reduced muscle function in the postoperative period [2].…”

Section: Sarcopenia In Surgical Patientsmentioning

confidence: 99%

Extending the benefit of nutrition intervention beyond the operative setting

Nogueira

Dock-Nascimento

Aguilar-Nascimento

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewTo provide an update of the recent evidence on the potential of perioperative nutritional interventions to benefit adult patients undergoing head and neck and digestive procedures. Recent findingsPerioperative nutrition within multimodal prehabilitation programs improve postoperative outcomes. Perioperative fasting time can be reduced with beverages containing carbohydrate alone or blended with a nitrogenous source such as whey protein; this approach seems to be safe and improve outcome. The choice of protein-containing formula, as well as diet composition to be recommended early during the postoperative refeeding, can be optimized to reduce complications. Sarcopenia is an important risk factor for surgical patients, as such, prehabilitation along with preoperative nutrition is strongly advised. Perioperative supplementation with b-hydroxy b-methylbutyrate to mitigate sarcopenia requires further investigation. Although perioperative nutritional interventions reduce healthcare costs, recent data suggest it has been scarcely prescribed.

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Association between low preoperative skeletal muscle quality and infectious complications following gastrectomy for gastric cancer

Cited by 7 publications

References 51 publications

High intramuscular adipose tissue content was a favorable prognostic factor in patients with advanced gastric cancer treated with nivolumab monotherapy

High intramuscular adipose tissue content was a favorable prognostic factor in patients with advanced gastric cancer treated with nivolumab monotherapy

Impact of Preoperative Handgrip Strength on Postoperative Outcome after Radical Gastrectomy for Gastric Cancer Patients

Extending the benefit of nutrition intervention beyond the operative setting

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