Association of Sarcopenia and Body Composition With Short-term Outcomes After Liver Resection for Malignant Tumors

Berardi, Giammauro; Antonelli, Giulio; Colasanti, Marco; Meniconi, Roberto Luca; Guglielmo, Nicola; Laurenzi, Andrea; Ferretti, Stefano; Sandri, Giovanni Battista Levi; Spagnoli, Alessandra; Moschetta, Giovanni; Schininà, Vincenzo; Antonini, Mario; Marignani, Massimo; Ettorre, Giuseppe Maria

doi:10.1001/jamasurg.2020.3336

Cited by 66 publications

(70 citation statements)

References 51 publications

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“…Beradi et al [ 38 ] analyzed a cohort of 234 patients undergoing liver resection for malignant tumors (hepatocellular carcinoma 43%, CRLM 41%). The patients’ characteristics were similar to ours regarding gender (67% male), age (median 66 years), BMI 27 kg/m 2 and extent of hepatectomy (major 27%).…”

Section: Discussionmentioning

confidence: 99%

“…There is no information of muscle strength in the present paper. In fact, there is only one study [ 38 ] that submits this information. Interestingly, loss of muscle mass increased the complication rate only in combination with reduced grip strength.…”

Section: Discussionmentioning

confidence: 99%

“…Lodewick et al [ 35 ] used thresholds of ≤41 cm 2 /m 2 in women, ≤43 cm 2 /m 2 in men with a BMI < 25 kg/m 2 and <53 cm/m 2 in men with a BMI > 25 kg/m 2 . Other cut-offs were: 53.5 cm 2 /m 2 in men and 40.8 cm 2 /m 2 in women [ 38 ] and 40.31 cm 2 /m 2 in men and 30.88 cm 2 /m 2 in women [ 28 ]. Simonsen et al identified 22 different definitions for sarcopenia [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

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The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

et al. 2021

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Background The impact of body compositions on surgical results is controversially discussed. This study examined whether visceral obesity, sarcopenia or sarcopenic obesity influence the outcome after hepatic resections of synchronous colorectal liver metastases. Methods Ninety-four consecutive patients with primary hepatic resections of synchronous colorectal metastases were identified from a single center database between January 2013 and August 2018. Patient characteristics and 30-day morbidity were retrospectively analyzed. Body fat and skeletal muscle were calculated by planimetry from single-slice CT images at the level of L3. Results Fifty-nine patients (62.8%) underwent minor hepatectomies, and 35 patients underwent major resections (37.2%). Postoperative complications occurred in 60 patients (62.8%) including 35 patients with major complications (Clavien–Dindo grade III–V). The mortality was nil at 30 days and 2.1% at 90 days. The body mass index showed no influence on postoperative outcomes (p = 1.0). Visceral obesity was found in 66 patients (70.2%) and was significantly associated with overall and major complication rates (p = .002, p = .012, respectively). Sarcopenia was observed in 34 patients (36.2%) without a significant impact on morbidity (p = .461), however, with longer hospital stay. Sarcopenic obesity was found in 18 patients (19.1%) and was significantly associated with postoperative complications (p = .014). Visceral obesity, sarcopenia and sarcopenic obesity were all identified as significant risk factors for overall postoperative complications. Conclusion Visceral obesity, sarcopenic obesity and sarcopenia are independent risk factors for overall complications after resections of CRLM. Early recognition of extremes in body compositions could prompt to perioperative interventions and thus improve postoperative outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

et al. 2021

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“…Recent studied have suggested that BMI measure may be biased and could provide inaccurate estimation of body composition and fat distribution because of its inadequacy to distinguish between muscle and adipose tissue [ 8 , 27 ]. Among novel techniques regarding biometric parameters, evaluations of computed tomography or magnetic resonance scans, cut at the level of the third lumbar vertebra, are emerging as promising and accurate approaches to provide a more precise assessment of body composition [ 28 ]. These evaluations require experienced radiologists and specific software that may measure cross-sectional areas of skeletal muscles and normalize them for height to obtain the skeletal muscle index (SMI).…”

Section: Detecting Malnutrition From the Very Beginning Of Cancer Care: Who Starts Well Is Half The Battlementioning

confidence: 99%

“…These evaluations require experienced radiologists and specific software that may measure cross-sectional areas of skeletal muscles and normalize them for height to obtain the skeletal muscle index (SMI). The prognostic value of these measures is very promising [ 28 ]. Bioelectric impedance analysis (BIA) is also a novel method, often used.…”

Section: Detecting Malnutrition From the Very Beginning Of Cancer Care: Who Starts Well Is Half The Battlementioning

confidence: 99%

The Clinical Value of Nutritional Care before and during Active Cancer Treatment

Aprile¹,

Basile²,

Giaretta³

et al. 2021

Nutrients

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Malnutrition and muscle wasting are frequently reported in cancer patients, either linked to the tumor itself or caused by oncologic therapies. Understanding the value of nutritional care during cancer treatment remains crucial. In fact, cancer-associated sarcopenia plays a key role in determining higher rates of morbidity, mortality, treatment-induced toxicities, prolonged hospitalizations and reduced adherence to anticancer treatment, worsening quality of life and survival. Planning baseline screening to intercept nutritional troubles earlier, organizing timely reassessments, and providing adequate counselling and dietary support, healthcare professional may positively interfere with this process and improve patients’ overall outcomes during the whole disease course. Several screening tools have been proposed for this purpose. Nutritional Risk Screening (NRS), Mini Nutritional Assessment (MNA), Patient Generated Subjective Global Assessment (PG-SGA) are the most common studied. Interestingly, second-level tools including skeletal muscle index (SMI) and bioelectric impedance analysis (BIA) provide a more precise assessment of body composition, even if they are more complex. However, nutritional assessment is not currently used in clinical practice and procedures must be standardized in order to improve the efficacy of standard chemotherapy, targeted agents or even checkpoint inhibitors that is potentially linked with the patients’ nutritional status. In the present review, we will discuss about malnutrition and the importance of an early nutritional assessment during chemotherapy and treatment with novel checkpoint inhibitors, in order to prevent treatment-induced toxicities and to improve survival outcomes.

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Association of Sarcopenia and Body Composition With Postoperative 90-Day Morbidity After Liver Resection for Malignant Tumors

2021

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and practitioners to identify individuals in urgent need of medical attention. The evidence available indicates that the ODI has excellent psychometric and structural properties, which is not the case for the Maslach Burnout Inventory, the most widely used measure of burnout. 4 Occupational health specialists have persistently come up against the problem of how to define and diagnose burnout, as illustrated again by the findings by Hewitt et al. 1 Somewhat surrealistically, studies claiming to estimate the prevalence of burnout have multiplied despite the absence of a diagnosis. By repatriating the topic of job-related distress in the well-established framework of depression, we have a chance to assess and promote the health of our workforce more effectively.

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Association of Sarcopenia and Body Composition With Short-term Outcomes After Liver Resection for Malignant Tumors

Cited by 66 publications

References 51 publications

The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

The Role of Visceral Obesity, Sarcopenia and Sarcopenic Obesity on Surgical Outcomes After Liver Resections for Colorectal Metastases

The Clinical Value of Nutritional Care before and during Active Cancer Treatment

Association of Sarcopenia and Body Composition With Postoperative 90-Day Morbidity After Liver Resection for Malignant Tumors

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