Sarcopenia Impacts on Short- and Long-term Results of Hepatectomy for Hepatocellular Carcinoma

To evaluate the prevalence of sarcopenia among European patients with resectable hepatocellular carcinoma (HCC) and to assess its prognostic impact on overall and disease-free survival. Identification of preoperative prognostic factors in liver surgery for HCC is required to better select patients a...

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Veröffentlicht in:	Annals of surgery Jg. 261; H. 6; S. 1173
Hauptverfasser:	Voron, Thibault, Tselikas, Lambros, Pietrasz, Daniel, Pigneur, Frederic, Laurent, Alexis, Compagnon, Philippe, Salloum, Chady, Luciani, Alain, Azoulay, Daniel
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States 01.06.2015
Schlagworte:	Aged Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - surgery Comorbidity Disease-Free Survival Female Hepatectomy - mortality Humans Liver Neoplasms - epidemiology Liver Neoplasms - surgery Male Middle Aged Neoplasm Recurrence, Local - epidemiology Patient Selection Prevalence Prognosis Retrospective Studies Sarcopenia - diagnostic imaging Sarcopenia - epidemiology Survival Analysis Tomography, X-Ray Computed Treatment Outcome
ISSN:	1528-1140, 1528-1140
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Abstract	To evaluate the prevalence of sarcopenia among European patients with resectable hepatocellular carcinoma (HCC) and to assess its prognostic impact on overall and disease-free survival. Identification of preoperative prognostic factors in liver surgery for HCC is required to better select patients and improve survival. Recent studies have shown that preoperative discrimination of patients with low skeletal muscle mass (sarcopenic patients) using computed tomography was associated with morbidity and mortality after liver and colorectal surgery. Assessment of sarcopenia could be used to evaluate patients before hepatectomy for HCC. All consecutive patients who underwent hepatectomy for HCC in our institution, between February 2006 and September 2012, were included. Univariate and multivariate analyses evaluating prognostic factors of postoperative mortality and cancer recurrence were performed, including preoperative, surgical, and histopathological factors. Among 198 patients who underwent hepatectomy for HCC, 109 patients had an available computed tomographic scan and represent the study cohort. After a median follow-up of 21.23 months, 27 patients (24.8%) died. There were 20 deaths among the 59 patients who had sarcopenia and only 7 deaths in the nonsarcopenic group. Sarcopenic patients had significantly shorter median overall survival than nonsarcopenic patients (52.3 months vs 70.3 months; P = 0.015). On multivariate analysis, sarcopenia was found to be an independent predictor of poor overall survival (hazard ratio = 3.19; P = 0.013) and disease-free survival (hazard ratio = 2.60; P = 0.001). Sarcopenia was found to be a strong and independent prognostic factor for mortality after hepatectomy for HCC in European patients and could be used to evaluate eligibility of patients with HCC before surgery.
AbstractList	To evaluate the prevalence of sarcopenia among European patients with resectable hepatocellular carcinoma (HCC) and to assess its prognostic impact on overall and disease-free survival. Identification of preoperative prognostic factors in liver surgery for HCC is required to better select patients and improve survival. Recent studies have shown that preoperative discrimination of patients with low skeletal muscle mass (sarcopenic patients) using computed tomography was associated with morbidity and mortality after liver and colorectal surgery. Assessment of sarcopenia could be used to evaluate patients before hepatectomy for HCC. All consecutive patients who underwent hepatectomy for HCC in our institution, between February 2006 and September 2012, were included. Univariate and multivariate analyses evaluating prognostic factors of postoperative mortality and cancer recurrence were performed, including preoperative, surgical, and histopathological factors. Among 198 patients who underwent hepatectomy for HCC, 109 patients had an available computed tomographic scan and represent the study cohort. After a median follow-up of 21.23 months, 27 patients (24.8%) died. There were 20 deaths among the 59 patients who had sarcopenia and only 7 deaths in the nonsarcopenic group. Sarcopenic patients had significantly shorter median overall survival than nonsarcopenic patients (52.3 months vs 70.3 months; P = 0.015). On multivariate analysis, sarcopenia was found to be an independent predictor of poor overall survival (hazard ratio = 3.19; P = 0.013) and disease-free survival (hazard ratio = 2.60; P = 0.001). Sarcopenia was found to be a strong and independent prognostic factor for mortality after hepatectomy for HCC in European patients and could be used to evaluate eligibility of patients with HCC before surgery. To evaluate the prevalence of sarcopenia among European patients with resectable hepatocellular carcinoma (HCC) and to assess its prognostic impact on overall and disease-free survival.OBJECTIVETo evaluate the prevalence of sarcopenia among European patients with resectable hepatocellular carcinoma (HCC) and to assess its prognostic impact on overall and disease-free survival.Identification of preoperative prognostic factors in liver surgery for HCC is required to better select patients and improve survival. Recent studies have shown that preoperative discrimination of patients with low skeletal muscle mass (sarcopenic patients) using computed tomography was associated with morbidity and mortality after liver and colorectal surgery. Assessment of sarcopenia could be used to evaluate patients before hepatectomy for HCC.BACKGROUNDIdentification of preoperative prognostic factors in liver surgery for HCC is required to better select patients and improve survival. Recent studies have shown that preoperative discrimination of patients with low skeletal muscle mass (sarcopenic patients) using computed tomography was associated with morbidity and mortality after liver and colorectal surgery. Assessment of sarcopenia could be used to evaluate patients before hepatectomy for HCC.All consecutive patients who underwent hepatectomy for HCC in our institution, between February 2006 and September 2012, were included. Univariate and multivariate analyses evaluating prognostic factors of postoperative mortality and cancer recurrence were performed, including preoperative, surgical, and histopathological factors.METHODSAll consecutive patients who underwent hepatectomy for HCC in our institution, between February 2006 and September 2012, were included. Univariate and multivariate analyses evaluating prognostic factors of postoperative mortality and cancer recurrence were performed, including preoperative, surgical, and histopathological factors.Among 198 patients who underwent hepatectomy for HCC, 109 patients had an available computed tomographic scan and represent the study cohort. After a median follow-up of 21.23 months, 27 patients (24.8%) died. There were 20 deaths among the 59 patients who had sarcopenia and only 7 deaths in the nonsarcopenic group. Sarcopenic patients had significantly shorter median overall survival than nonsarcopenic patients (52.3 months vs 70.3 months; P = 0.015). On multivariate analysis, sarcopenia was found to be an independent predictor of poor overall survival (hazard ratio = 3.19; P = 0.013) and disease-free survival (hazard ratio = 2.60; P = 0.001).RESULTSAmong 198 patients who underwent hepatectomy for HCC, 109 patients had an available computed tomographic scan and represent the study cohort. After a median follow-up of 21.23 months, 27 patients (24.8%) died. There were 20 deaths among the 59 patients who had sarcopenia and only 7 deaths in the nonsarcopenic group. Sarcopenic patients had significantly shorter median overall survival than nonsarcopenic patients (52.3 months vs 70.3 months; P = 0.015). On multivariate analysis, sarcopenia was found to be an independent predictor of poor overall survival (hazard ratio = 3.19; P = 0.013) and disease-free survival (hazard ratio = 2.60; P = 0.001).Sarcopenia was found to be a strong and independent prognostic factor for mortality after hepatectomy for HCC in European patients and could be used to evaluate eligibility of patients with HCC before surgery.CONCLUSIONSSarcopenia was found to be a strong and independent prognostic factor for mortality after hepatectomy for HCC in European patients and could be used to evaluate eligibility of patients with HCC before surgery.
Author	Tselikas, Lambros Pietrasz, Daniel Azoulay, Daniel Laurent, Alexis Voron, Thibault Compagnon, Philippe Salloum, Chady Luciani, Alain Pigneur, Frederic
Author_xml	– sequence: 1 givenname: Thibault surname: Voron fullname: Voron, Thibault organization: Departments of Digestive and Hepatobiliary Surgery †Radiology, Henri-Mondor Hospital, AP-HP, Créteil, France ‡Université Paris Est, Faculté de Médecine Créteil, Créteil, France; and §INSERM, U 955, Equipe 18, Creteil, F-94010, France – sequence: 2 givenname: Lambros surname: Tselikas fullname: Tselikas, Lambros – sequence: 3 givenname: Daniel surname: Pietrasz fullname: Pietrasz, Daniel – sequence: 4 givenname: Frederic surname: Pigneur fullname: Pigneur, Frederic – sequence: 5 givenname: Alexis surname: Laurent fullname: Laurent, Alexis – sequence: 6 givenname: Philippe surname: Compagnon fullname: Compagnon, Philippe – sequence: 7 givenname: Chady surname: Salloum fullname: Salloum, Chady – sequence: 8 givenname: Alain surname: Luciani fullname: Luciani, Alain – sequence: 9 givenname: Daniel surname: Azoulay fullname: Azoulay, Daniel
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/24950264$$D View this record in MEDLINE/PubMed
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PublicationTitle	Annals of surgery
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Snippet	To evaluate the prevalence of sarcopenia among European patients with resectable hepatocellular carcinoma (HCC) and to assess its prognostic impact on overall...
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SubjectTerms	Aged Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - surgery Comorbidity Disease-Free Survival Female Hepatectomy - mortality Humans Liver Neoplasms - epidemiology Liver Neoplasms - surgery Male Middle Aged Neoplasm Recurrence, Local - epidemiology Patient Selection Prevalence Prognosis Retrospective Studies Sarcopenia - diagnostic imaging Sarcopenia - epidemiology Survival Analysis Tomography, X-Ray Computed Treatment Outcome
Title	Sarcopenia Impacts on Short- and Long-term Results of Hepatectomy for Hepatocellular Carcinoma
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