Clinical utility of sarcopenia dynamics assessed by psoas muscle volume in patients with colorectal cancer.

IF 2.3 3区医学 Q2 SURGERY World Journal of Surgery Pub Date : 2024-08-02 DOI:10.1002/wjs.12302

Tomotaka Kumamoto, Yasuyuki Takamizawa, Mototaka Miyake, Manabu Inoue, Konosuke Moritani, Shunsuke Tsukamoto, Ken Eto, Yukihide Kanemitsu

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Abstract

Background: Sarcopenia affects the postoperative prognosis of patients with colorectal cancer (CRC). Recently, it has become possible to measure psoas volume from computed tomography images, and an index called psoas volume index (PVI) has been reported. However, it is unclear whether the dynamics of PVI before and after surgery is associated with clinical outcomes after CRC surgery. This study aimed to evaluate the association between pre- and postoperative PVI dynamics and clinical outcomes after CRC surgery.

Methods: This study analyzed 1115 patients diagnosed with primary CRC and operated on for treatment between January 2014 and December 2017. Sarcopenia was defined as PVI below the lowest tertile in the preoperative assessment for each sex. The overall population was divided into four groups according to the dynamics of sarcopenia from preoperative to postoperative: group 1 (pre-to postoperative sarcopenia), group 2 (preoperative nonsarcopenia to postoperative sarcopenia), group 3 (pre-to postoperative nonsarcopenia), and group 4 (pre-to postoperative nonsarcopenia).

Results: Based on pre- and postoperative sarcopenia dynamics, 343 patients (29.7%) were classified into group 1, 105 patients (9.1%) into group 2, 42 patients (3.6%) into group 3, and 665 patients (57.6%) into group 4. Comparison of overall survival (OS) by the Kaplan-Meier method showed that Group 2 tended to have the worst prognosis (p = 0.007). Multivariate analysis showed an increased OS risk in Group 2 in sarcopenia dynamics (Hazard ratio: 2.103, 95% CI: 1.202-3.681, p = 0.009).

Conclusions: Sarcopenia dynamics using PVI is an independent prognostic predictor of OS in patients with CRC.

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通过腰肌体积评估大肠癌患者肌少症动态的临床实用性。

背景：肌肉疏松症会影响结直肠癌（CRC）患者的术后预后。最近，人们可以通过计算机断层扫描图像测量腰肌体积，并报道了一种称为腰肌体积指数（PVI）的指标。然而，目前还不清楚手术前后 PVI 的动态变化是否与 CRC 手术后的临床结果有关。本研究旨在评估术前和术后 PVI 动态与 CRC 手术后临床结果之间的关联：本研究分析了2014年1月至2017年12月期间确诊为原发性CRC并接受手术治疗的1115例患者。肢体减少症的定义是：PVI 低于术前评估的最低三分位数。根据肌少症从术前到术后的动态变化，将总体人群分为四组：第1组（术前至术后肌少症）、第2组（术前非肌少症至术后肌少症）、第3组（术前至术后非肌少症）和第4组（术前至术后非肌少症）：根据术前和术后肌肉疏松症的动态变化，343 名患者（29.7%）被分为第 1 组，105 名患者（9.1%）被分为第 2 组，42 名患者（3.6%）被分为第 3 组，665 名患者（57.6%）被分为第 4 组。多变量分析显示，肌少症动态组 2 的 OS 风险增加（危险比：2.103，95% CI：1.202-3.681，p = 0.009）：使用 PVI 进行肌营养不良动态分析是预测 CRC 患者 OS 的独立预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgery 医学-外科

CiteScore

5.10

自引率

3.80%

发文量

460

审稿时长

3 months

期刊介绍： World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.