The prognostic impact of sarcopenia on elderly patients undergoing pulmonary resection for non-small cell lung cancer

Miura, Akihiro; Yamamoto, Hiromasa; Sato, Hiroki; Tomioka, Yasuaki; Shiotani, Toshio; Suzawa, Ken; Miyoshi, Kentaroh; Otani, Shinji; Okazaki, Mikio; Sugimoto, Seiichiro; Yamane, Masaomi; Toyooka, Shinichi

doi:10.1007/s00595-020-02221-1

Cited by 9 publications

(3 citation statements)

References 38 publications

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“…Furthermore, neither VFA nor myosteatosis had a significant impact on the postoperative course in this cohort. The high rate of sarcopenia in our cohort is comparable with other studies [ 27 ]. The comparatively low number of overall complications (17.2%) and anastomotic leakage (4.0%) in this selected cohort seems remarkable and may be attributed to the effect of advanced minimally invasive laparoscopic surgery.…”

Section: Discussionsupporting

confidence: 92%

Effects of sarcopenia and myosteatosis are alleviated in reduced port surgery for diverticulitis

Schaffler-Schaden,

Mittermair,

Bittner

et al. 2023

Int J Colorectal Dis

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Purpose Many studies report the predictive value of sarcopenia, myosteatosis, and visceral fat for clinical outcome after surgery. Radiological analysis of body composition is a valuable tool for identifying high-risk patients undergoing major abdominal surgery. Despite the high prevalence of diverticular disease, patients with benign conditions have hardly been studied in this context. This study aims to evaluate the impact of reduced port surgery on the outcome of patients with diverticulitis, adjusting for body composition. Methods We assessed body composition profiles using preoperative CT slices at the level of the third lumbar vertebra in consecutive patients undergoing single-port elective surgery for diverticulitis in a single center. The effects of sarcopenia, myosteatosis, and visceral fat on mortality and complications were analyzed and adjusted for age and gender. Results We enrolled 99 patients with diverticulitis undergoing elective single port surgery in this study. Of the patients, 71.2% had sarcopenia and 60.6% had myosteatosis. The overall complication rate was 17.2%, and the rate of anastomotic leakage was 4.0%. Thirty-day mortality was 2.0%. Loss of skeletal muscle mass, myosteatosis, and visceral fat were not associated with higher complication or mortality rates in our cohort. Conclusion Body composition profiles had no impact on the clinical course in our cohort. Minimally invasive surgery may potentially compensate for the adverse effects of sarcopenia and myosteatosis in diverticulitis.

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Section: Discussionsupporting

confidence: 92%

Effects of sarcopenia and myosteatosis are alleviated in reduced port surgery for diverticulitis

Schaffler-Schaden,

Mittermair,

Bittner

et al. 2023

Int J Colorectal Dis

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“…Median OS was 63. (34). Whether this association in the older patients is an expression of a reduced nutritional status or an increased catabolic situation due to the tumor disease remains controversial.…”

Section: Multivariate Analysis Of Long-term Surgicalmentioning

confidence: 99%

Peri- and postoperative morbidity and mortality in elderly patients with non-small cell lung cancer: a matched-pair study

Safi,

Gysan,

Weber

et al. 2024

Preprint

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Background Reports from case series suggest that operative outcomes are comparable amongst different age groups following surgery with curative intent for non-small cell lung cancer (NSCLC). The purpose of this study was to compare morbidity and mortality after NSCLC surgery in elderly patients (≥ 75 years) versus younger patients (< 75 years) and identify independent predictive risk factors. Methods We identified 2015 patients with postoperative stages IA to IIIA according to AJCC/UICC 7th edition who had undergone NSCLC surgery with curative intent at a single specialized lung cancer center from January 2010 to December 2015. A matched-pair analysis was performed on 227 elderly patients and corresponding 227 younger patients. Short-term surgical outcomes were postoperative morbidity, length of hospital stay, 30-day and 90-day mortality. Long-term operative outcomes were disease-free and overall survival. Results 454 patients were included in the matched-pair analysis. 36% of younger patients developed postoperative complications versus 42% in the elderly (p = 0.163). Age was not significantly associated with the occurrence of postoperative complications. Median length of hospital stay was 14 days in elderly and 13 days in younger patients (p = 0.185). 90-day mortality was 2.2% in younger patients compared to 4% in the elderly (p = 0.424). In the elderly impaired performance status (ECOG ≥ 1) was associated with decreased overall survival (HR = 2.15, CI 1.34–3.46), as were preoperative serum C-reactive protein / albumin ratio ≥ 0.3 (HR = 1.95, CI 1.23–3.11) and elevated preoperative serum creatinine levels ≥ 1.1 mg/dl (HR = 1.84, CI 1.15–2.95). In the younger cohort male sex (HR = 2.26, CI 1.17–4.36), postoperative stage III disease (HR 4.61, CI 2.23–9.54) and preoperative anemia (hemoglobin < 12 g/dl) (HR 2.09, CI 1.10–3.96) were associated with decreased overall survival. Conclusions Preoperative treatment decision-making in the elderly should primarily consider individual assessment of patients’ functional performance and general fitness. Patients should not be excluded from surgery for resectable NSCLC due to advanced age.

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“…Many reports evaluate the thoracic muscle group, paraspinal muscles and iliopsoas muscles using thoracoabdominal CT, routinely taken in clinical practice, [77][78][79] although few have evaluated respiratory muscle strength. Most reports are only at the preoperative stage and in operable patients, which may have potential selection bias.…”

Section: Prevalencementioning

confidence: 99%

Respiratory sarcopenia: A position paper by four professional organizations

Satô

Miyazaki

Tamaki

et al. 2022

Geriatrics Gerontology Int

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We defined respiratory sarcopenia as a coexistence of respiratory muscle weakness and decreased respiratory muscle mass. Although respiratory muscle function is indispensable for life support, its evaluation has not been included in the regular assessment of respiratory function or adequately evaluated in clinical practice. Considering this situation, we prepared a position paper outlining basic knowledge, diagnostic and assessment methods, mechanisms, involvement in respiratory diseases, intervention and treatment methods, and future perspectives on respiratory sarcopenia, and summarized the current consensus on respiratory sarcopenia. Respiratory sarcopenia is diagnosed when respiratory muscle weakness and decreased respiratory muscle mass are observed. If respiratory muscle mass is difficult to measure, we can use appendicular skeletal muscle mass as a surrogate. Probable respiratory sarcopenia is defined when respiratory muscle weakness and decreased appendicular skeletal muscle mass are observed. If only respiratory muscle strength is decreased without a decrease in respiratory function, the patient is diagnosed with possible respiratory sarcopenia. Respiratory muscle strength is assessed using maximum inspiratory pressure and maximum expiratory pressure. Ultrasonography and computed tomography are commonly used to assess respiratory muscle mass; however, there are insufficient data to propose the cutoff values for defining decreased respiratory muscle mass. It was jointly prepared by the representative authors and authorized by the Japanese Society for Respiratory Care and Rehabilitation,

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The prognostic impact of sarcopenia on elderly patients undergoing pulmonary resection for non-small cell lung cancer

Cited by 9 publications

References 38 publications

Effects of sarcopenia and myosteatosis are alleviated in reduced port surgery for diverticulitis

Effects of sarcopenia and myosteatosis are alleviated in reduced port surgery for diverticulitis

Peri- and postoperative morbidity and mortality in elderly patients with non-small cell lung cancer: a matched-pair study

Respiratory sarcopenia: A position paper by four professional organizations

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