Body composition and outcome in patients undergoing resection of colorectal liver metastases19

British Journal of Surgery - Tập 99 Số 4 - Trang 550-557 - 2012
Mark G. van Vledder1, Stef Levolger1, Ninos Ayez1, Cornelis Verhoef1, T.C.K. Tran1, Jan N.M. IJzermans1
1Department of Surgery, Erasmus MC, Rotterdam, 'S Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.

Tóm tắt

Abstract Background Recent evidence suggests that depletion of skeletal muscle mass (sarcopenia) and an increased amount of intra-abdominal fat (central obesity) influence cancer statistics. This study investigated the impact of sarcopenia and central obesity on survival in patients undergoing liver resection for colorectal liver metastases (CLM). Methods Diagnostic imaging from patients who had hepatic resection for CLM in one centre between 2001 and 2009, and who had assessable perioperative computed tomograms, was analysed retrospectively. Total cross-sectional areas of skeletal muscle and intra-abdominal fat, and their influence on outcome, were analysed. Results Of the 196 patients included in the study, 38 (19·4 per cent) were classified as having sarcopenia. Five-year disease-free (15 per cent versus 28·5 per cent in patients without sarcopenia; P = 0·002) and overall (20 per cent versus 49·9 per cent respectively; P < 0·001) survival rates were lower for patients with sarcopenia at a median follow-up of 29 (range 1–97) months. Sarcopenia was an independent predictor of worse recurrence-free (hazard ratio (HR) 1·88, 95 per cent confidence interval 1·25 to 2·82; P = 0·002) and overall (HR 2·53, 1·60 to 4·01; P < 0·001) survival. Central obesity was associated with an increased risk of recurrence in men (P = 0·032), but not in women (P = 0·712). Conclusion Sarcopenia has a negative impact on cancer outcomes following resection of CLM.

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Tài liệu tham khảo

Al-Asfoor, 2008, Resection versus no intervention or other surgical interventions for colorectal cancer liver metastases, Cochrane Database Syst Rev, CD006039

de Jong, 2009, Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients, Ann Surg, 250, 440, 10.1097/SLA.0b013e3181b4539b

van der Pool, 2010, Trends in treatment for synchronous colorectal liver metastases: differences in outcome before and after 2000, J Surg Oncol, 102, 413, 10.1002/jso.21618

Lalmahomed, 2011, Anatomical versus nonanatomical resection of colorectal liver metastases: is there a difference in surgical and oncological outcome?, World J Surg, 35, 656, 10.1007/s00268-010-0890-9

Pathak, 2010, Hepatic steatosis, body mass index and long term outcome in patients undergoing hepatectomy for colorectal liver metastases, Eur J Surg Oncol, 36, 52, 10.1016/j.ejso.2009.09.004

Nikfarjam, 2009, Survival outcomes of patients with colorectal liver metastases following hepatic resection or ablation in the era of effective chemotherapy, Ann Surg Oncol, 16, 1860, 10.1245/s10434-008-0225-3

Moon, 2008, Visceral obesity may affect oncologic outcome in patients with colorectal cancer, Ann Surg Oncol, 15, 1918, 10.1245/s10434-008-9891-4

Prado, 2008, Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study, Lancet Oncol, 9, 629, 10.1016/S1470-2045(08)70153-0

Tan, 2009, Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer, Clin Cancer Res, 15, 6973, 10.1158/1078-0432.CCR-09-1525

Englesbe, 2010, Sarcopenia and mortality after liver transplantation, J Am Coll Surg, 211, 271, 10.1016/j.jamcollsurg.2010.03.039

Balentine, 2010, Intra-abdominal fat predicts survival in pancreatic cancer, J Gastrointest Surg, 14, 1832, 10.1007/s11605-010-1297-5

Yoshizumi, 1999, Abdominal fat: standardized technique for measurement at CT, Radiology, 211, 283, 10.1148/radiology.211.1.r99ap15283

Mitsiopoulos, 1998, Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography, J Appl Physiol, 85, 115, 10.1152/jappl.1998.85.1.115

Fong, 1999, Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases, Ann Surg, 230, 309, 10.1097/00000658-199909000-00004

Dodson, 2011, Muscle wasting in cancer cachexia: clinical implications, diagnosis, and emerging treatment strategies, Annu Rev Med, 62, 265, 10.1146/annurev-med-061509-131248

Janssen, 2002, Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability, J Am Geriatr Soc, 50, 889, 10.1046/j.1532-5415.2002.50216.x

Fearon, 2006, Definition of cancer cachexia: effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis, Am J Clin Nutr, 83, 1345, 10.1093/ajcn/83.6.1345

Makary, 2010, Frailty as a predictor of surgical outcomes in older patients, J Am Coll Surg, 210, 901, 10.1016/j.jamcollsurg.2010.01.028

Kim, 2010, The frequency and risk factors of colorectal adenoma in health-check-up subjects in South Korea: relationship to abdominal obesity and age, Gut Liver, 4, 36, 10.5009/gnl.2010.4.1.36

Huang, 2009, Obesity, the PI3K/Akt signal pathway and colon cancer, Obes Rev, 10, 610, 10.1111/j.1467-789X.2009.00607.x

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British Journal of Surgery

Tập 99 Số 4

550-557

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