Sarcopenia predicts reduced liver growth and reduced resectability in patients undergoing portal vein embolization before liver resection - A DRAGON collaborative analysis of 306 patients

Heil, Jan; Heid, F.; Bechstein, Wolf O.; Björnsson, Bergþór; Brismar, Torkel B.; Carling, Ulrik; Erdmann, Joris I.; Grünhagen, Dirk J.; Hana, Renato A.; Hohmann, Joachim; Linke, R.; Meyer, Yannick; Nawawi, Abrar; Olthof, Pim B.; Sandström, Per; Schnitzbauer, Andreas A.; Sparrelid, Ernesto; Verhoef, Cornelis; Metrakos, Peter; Schadde, Erik

doi:10.1016/j.hpb.2021.08.818

Cited by 7 publications

(16 citation statements)

References 31 publications

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“…In the ALPPS research which dichotomized patients into low and high kinetic growth rate groups by a kinetic growth rate cutoff value of 7.0%/week, a degree of hypertrophy of 11% and 18% was observed in the two groups respectively (30) (Table 3). Compared with a kinetic growth rate of 2.6-4.0%/week in the non-sarcopenia group, the sarcopenia group demonstrated a significantly lower kinetic growth rate of 2.0%/week in two studies (27,29). One study reported an overall kinetic growth rate of 3.6%/week for the whole study cohort (26).…”

Section: Liver Growth Ratementioning

confidence: 95%

“…Overall resection rate was reported to be 83% and 73% respectively in two of the PVE studies (28,29) and 87% in the ALPPS study (30). One study reported a significantly lower resection rate after PVE in the sarcopenia group, compared with the non-sarcopenia group (66% vs 87%) (29).…”

Section: Post-treatment Complications Post-hepatectomy Liver Failure ...mentioning

confidence: 98%

“…In the three studies that performed multivariable logistic regression analysis, all identified sarcopenia as an independent factor for poor FLR growth (28)(29)(30). The other independent variables detected were initial FLR volume, total bilirubin level, and body mass index.…”

Section: Liver Growth Ratementioning

confidence: 99%

“…Systematic literature searching initially yielded 187 records from the four electronic databases. After the removal of ineligible studies (duplications (40), inappropriate form of research (71), animal research/case report (5), studies not related to portal vein occlusion or sarcopenia (63), and no liver growth indices available (3)), five studies remained for inclusion in this systematic review (26)(27)(28)(29)(30). The process of study selection is shown in Figure 1 and Supplementary Table S3.…”

Section: Study Characteristics and Research Quality Assessmentmentioning

confidence: 99%

“…All body composition analyses were based on pretreatment computed tomography (CT) images: two studies stated the CT image phase used (one without contrast media and the other on images obtained in the portal venous phase) (26,28). A slice thickness of 5 mm was reported in three studies (26,29,30), while slice thickness was not reported in two (27,28). All studies measured the skeletal muscle area (at the level of the third lumber vertebra), which was converted into skeletal muscle index by being divided by squared height (m 2 ).…”

Section: Skeletal Muscle Measurement and Definition Of Sarcopeniamentioning

confidence: 99%

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Impact of sarcopenia on the future liver remnant growth after portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy in patients with liver cancer: A systematic review

Wang

et al. 2022

Front. Oncol.

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PurposeThe impact of sarcopenia on the future liver remnant (FLR) growth after portal vein occlusion, including portal vein embolization (PVE) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has gained increasing interest. This systematic review aimed to explore whether sarcopenia was associated with insufficient FLR growth after PVE/ALPPS stage-1.MethodsA systematic literature search was performed in PubMed, Embase, Web of Science, and Cochrane Library up to 05 July 2022. Studies evaluating the influence of sarcopenia on FLR growth after PVE/ALPPS stage-1 in patients with liver cancer were included. A predefined table was used to extract information including the study and patient characteristics, sarcopenia measurement, FLR growth, post-treatment complications and post-hepatectomy liver failure, resection rate. Research quality was evaluated by the Newcastle-Ottawa Scale.ResultsFive studies consisting of 609 patients were included in this study, with a sample size ranging from 42 to 306 (median: 90) patients. Only one study was multicenter research. The incidence of sarcopenia differed from 40% to 67% (median: 63%). Skeletal muscle index based on pretreatment computed tomography was the commonly used parameter for sarcopenia evaluation. All included studies showed that sarcopenia impaired the FLR growth after PVE/ALPPS stage-1. However, the association between sarcopenia and post-treatment complications, post-hepatectomy liver failure, and resection rate remains unclear. All studies showed moderate-to-high quality.ConclusionsSarcopenia seems to be prevalent in patients undergoing PVE/ALPPS and may be a risk factor for impaired liver growth after PVE/ALPPS stage-1 according to currently limited evidence.Systematic review registrationhttps://inplasy.com/, identifier INPLASY202280038.

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Section: Liver Growth Ratementioning

confidence: 95%

Section: Post-treatment Complications Post-hepatectomy Liver Failure ...mentioning

confidence: 98%

Section: Liver Growth Ratementioning

confidence: 99%

Section: Study Characteristics and Research Quality Assessmentmentioning

confidence: 99%

Section: Skeletal Muscle Measurement and Definition Of Sarcopeniamentioning

confidence: 99%

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Impact of sarcopenia on the future liver remnant growth after portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy in patients with liver cancer: A systematic review

Wang

et al. 2022

Front. Oncol.

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Effect of Sarcopenia on the Increase in Liver Volume and Function After Portal Vein Embolization

Arntz,

Olthof,

Korenblik

et al. 2024

Cardiovasc Intervent Radiol

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Purpose Sarcopenia is associated with a decreased kinetic growth rate (KGR) of the future liver remnant (FLR) after portal vein embolization (PVE). However, little is known on the increase in FLR function (FLRF) after PVE. This study evaluated the effect of sarcopenia on the functional growth rate (FGR) after PVE measured with hepatobiliary scintigraphy (HBS). Methods All patients who underwent PVE at the Amsterdam UMC between January 2005 and August 2017 were analyzed. Functional imaging by HBS was used to determine FGR. Liver volumetry was performed using multiphase contrast computed tomography (CT). Muscle area measurement to determine sarcopenia was taken at the third lumbar level (L3). Results Out of the 95 included patients, 9 were excluded due to unavailable data. 70/86 (81%) patients were sarcopenic. In the multivariate logistic regression analysis, sarcopenia (p = 0.009) and FLR volume (FRLV) before PVE (p = 0.021) were the only factors correlated with KGR, while no correlation was found with FGR. 90-day mortality was similar across the sarcopenic and non-sarcopenic group (4/53 [8%] versus 1/11 [9%]; p = 1.000). The resection rates were also comparable (53/70 [75%] versus 11/16 [69%]; p = 0.542). Conclusion FGR after PVE as measured by HBS appears to be preserved in sarcopenic patients. This is in contrast to KGR after PVE as measured by liver volumetry which is decreased in sarcopenic patients. Level of Evidence Level 3b, cohort and case control studies.

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Effect of Sarcopenia on the Increase in Liver Volume and Function After Portal Vein Embolization: A Comment

Carling

2024

Cardiovasc Intervent Radiol

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Sarcopenia predicts reduced liver growth and reduced resectability in patients undergoing portal vein embolization before liver resection - A DRAGON collaborative analysis of 306 patients

Cited by 7 publications

References 31 publications

Impact of sarcopenia on the future liver remnant growth after portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy in patients with liver cancer: A systematic review

Impact of sarcopenia on the future liver remnant growth after portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy in patients with liver cancer: A systematic review

Effect of Sarcopenia on the Increase in Liver Volume and Function After Portal Vein Embolization

Effect of Sarcopenia on the Increase in Liver Volume and Function After Portal Vein Embolization: A Comment

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