Skeletal-muscle index predicts survival after percutaneous transhepatic biliary drainage for obstructive jaundice due to perihilar cholangiocarcinoma

Surgical Endoscopy And Other Interventional Techniques - Tập 35 - Trang 6073-6080 - 2020
Jin-Xing Zhang1, Ye Ding2, Hai-Tao Yan1, Chun-Gao Zhou1, Jin Liu3, Sheng Liu1, Qing-Quan Zu1, Hai-Bin Shi1
1Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
2Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
3Department of Clinical Medicine Research Institution, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China

Tóm tắt

Sarcopenia is emerging as a prognostic factor in patients with malignant diseases. The prognostication of perihilar cholangiocarcinoma (PHC) with obstructive jaundice was complex, because these patients suffered compete mortality events beyond cancer itself. Our study was to investigate the association between low skeletal-muscle index and overall survival (OS) after percutaneous transhepatic biliary drainage (PTBD) for obstructive jaundice due to PHC. We performed a retrospective survival analysis of patients undergoing PTBD for PHC-related obstructive jaundice between January 2016 and March 2019. Using computed tomography, we measured skeletal-muscle mass at the third lumbar vertebra (L3) to obtain a skeletal-muscle index (SMI). Then, we compared OS between low- and high-SMI groups. Furthermore, factors that could potentially affect OS were assessed. One hundred and four patients (56 males; mean age 66 ± 12 years) were analyzed. Median OS after PTBD was 150 days. OS was shorter in patients with low SMI than in those with high SMI (median OS, 120 vs. 270 days; P < 0.001). Multivariate analysis indicated that low SMI (hazard ratio [HR] 3.46; 95% confidence interval [CI] 1.14–5.60; P < 0.001), intrahepatic metastasis (HR 2.98; 95% CI 1.89–4.69; P < 0.001) and elevated carbohydrate antigen (CA) 19–9 level (HR 1.00; 95% CI 1.00–1.00; P = 0.04) were significantly associated with OS. Low SMI was a predictor of dismal OS after PTBD for patients with PHC-related obstructive jaundice.

Tài liệu tham khảo

Razumilava N, Gores GJ (2014) Cholangiocarcinoma. Lancet 383:2168–2179

Bridgewater J, Galle PR, Khan SA et al (2014) Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. J Hepatol 60:1268–1289

Rizvi S, Khan SA, Hallemeier CL, Kelley RK, Gores GJ (2018) Cholangiocarcinoma—evolving concepts and therapeutic strategies. Nat Rev Clin Oncol 15:95–111

Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T et al (2013) Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol 28:593–607

Shim DJ, Gwon DI, Han K et al (2018) Percutaneous metallic stent placement for palliative management of malignant biliary hilar obstruction. Korean J Radiol 19:597–605

Zhu HD, Guo JH, Huang M et al (2018) Irradiation stents vs. conventional metal stents for unresectable malignant biliary obstruction: a multicenter trial. J Hepatol 68:970–977

Kasai K, Kooka Y, Suzuki Y et al (2014) Efficacy of hepatic arterial infusion chemotherapy using 5-fluorouracil and systemic pegylated interferon α-2b for advanced intrahepatic cholangiocarcinoma. Ann Surg Oncol 21:3638–3645

Zhang JX, Wang B, Liu S, Zu QQ, Shi HB (2019) Predictors of recurrent biliary obstruction following percutaneous uncovered metal stent insertion in patients with distal malignant biliary obstruction: an analysis using a competing risk model. Cardiovasc Intervent Radiol 42:276–282

Li M, Li K, Qi X et al (2016) Percutaneous transhepatic biliary stent implantation for obstructive jaundice of perihilar cholangiocarcinoma: a prospective study on predictors of stent patency and survival in 92 patients. J Vasc Interv Radiol 27:1047-1055.e2

Chaiteerakij R, Harmsen WS, Marrero CR et al (2014) A new clinically based staging system for perihilar cholangiocarcinoma. Am J Gastroenterol 109:1881–1890

Ruzzenente A, Bagante F, Ardito F et al (2018) Comparison of the 7th and 8th editions of the American joint committee on cancer staging systems for perihilar cholangiocarcinoma. Surgery 146:244–250

Fujita M, Takahashi A, Hayashi M, Okai K, Abe K, Ohira H (2019) Skeletal muscle volume loss during transarterial chemoembolization predicts poor prognosis in patients with hepatocellular carcinoma. Hepatol Res 49:778–786

Naumann P, Eberlein J, Farnia B, Hackert T, Debus J, Combs SE (2019) Continued weight loss and sarcopenia predict poor outcomes in locally advanced pancreatic cancer treated with chemoradiation. Cancers. https://doi.org/10.3390/cancers11050709

Fidler MJ, Borgia JA, Bonomi PD, Shah P (2019) Prognostic significance of skeletal muscle loss during early postoperative period in elderly patients with esophageal cancer. Ann Surg Oncol 26:3807–3808

Nishikawa H, Enomoto H, Ishii A et al (2017) Comparison of prognostic impact between the child-pugh score and skeletal muscle mass for patients with liver cirrhosis. Nutrients. https://doi.org/10.3390/nu9060595

Chakedis J, Spolverato G, Beal EW et al (2018) Pre-operative sarcopenia identifies patients at risk for poor survival after resection of biliary tract cancers. J Gastrointest Surg 22:1697–1708

Clugston A, Paterson HM, Yuill K, Garden OJ, Parks RW (2006) Nutritional risk index predicts a high-risk population in patients with obstructive jaundice. Clin Nutr 25:949–954

Gong Q, Zhu P, Zhang B et al (2018) Safety and efficacy of n-3 fatty acid-based parenteral nutrition in patients with obstructive jaundice: a propensity-matched study. Eur J Clin Nutr 72:1159–1166

Albano D, Messina C, Vitale J, Sconfienza LM (2020) Imaging of sarcopenia: old evidence and new insights. Eur Radiol 30:2199–2208

Isayama H, Hamada T, Yasuda I et al (2015) TOKYO criteria 2014 for transpapillary biliary stenting. Dig Endosc 27:259–264

Cardella JF, Kundu S, Miller DL, Millward SF, Sacks D, Society of Interventional Radiology (2009) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 20:S189-191

Hothorn T, Lausen B (2003) On the exact distribution of maximally selected rank statistics. Comput Stat Data Anal 43:121–137

Wright MN, Dankowski T, Ziegler A (2017) Unbiased split variable selection for random survival forests using maximally selected rank statistics. Stat Med 36:1272–1284

Pavlidis ET, Pavlidis TE (2018) Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int 17:17–21

Zhou HF, Lu J, Zhu HD et al (2019) Early warning models to estimate the 30-day mortality risk after stent placement for patients with malignant biliary obstruction. Cardiovasc Intervent Radiol 42:1751–1759

Fearon K, Strasser F, Anker SD et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495

Daly LE, Prado CM, Ryan AM (2018) A window beneath the skin: how computed tomography assessment of body composition can assist in the identification of hidden wasting conditions in oncology that profoundly impact outcomes. Proc Nutr Soc 77:135–151

Suzuki Y, Okamoto T, Fujishita T et al (2016) Clinical implications of sarcopenia in patients undergoing complete resection for early non-small cell lung cancer. Lung Cancer 101:92–97

Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31

Nishikawa H, Shiraki M, Hiramatsu A, Moriya K, Hino K, Nishiguchi S (2016) Japan Society of hepatology guidelines for sarcopenia in liver disease (1st edition): recommendation from the working group for creation of sarcopenia assessment criteria. Hepatol Res 46:951–963

Distefano G, Standley RA, Zhang X et al (2018) Physical activity unveils the relationship between mitochondrial energetics, muscle quality, and physical function in older adults. J Cachexia Sarcopenia Muscle 9:279–294

Rock CL, Doyle C, Demark-Wahnefried W et al (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62:243–274

Blair CK, Robien K, Inoue-Choi M, Rahn W, Lazovich D (2016) Physical inactivity and risk of poor quality of life among elderly cancer survivors compared to women without cancer: the Iowa Women’s Health Study. J Cancer Surv 10:103–112

Imai K, Takai K, Watanabe S et al (2017) Sarcopenia impairs prognosis of patients with hepatocellular carcinoma: the role of liver functional reserve and tumor-related factors in loss of skeletal muscle volume. Nutrients. https://doi.org/10.3390/nu9101054,Sep22

Thông tin
Thông tin xuất bản

Surgical Endoscopy And Other Interventional Techniques

Tập 35

6073-6080

Thông tin tác giả