Impacts of Preoperative Psoas Muscle Mass and Visceral Fat Area on Postoperative Short- and Long-Term Outcomes in Patien
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ORIGINAL SCIENTIFIC REPORT
Impacts of Preoperative Psoas Muscle Mass and Visceral Fat Area on Postoperative Short- and Long-Term Outcomes in Patients with Gastric Cancer Yoshiki Taniguchi1,2 • Yukinori Kurokawa1 • Tsuyoshi Takahashi1 • Takuro Saito1 Kotaro Yamashita1 • Koji Tanaka1 • Tomoki Makino1 • Makoto Yamasaki1 • Kiyokazu Nakajima1 • Hidetoshi Eguchi1 • Yuichiro Doki1
•
Accepted: 25 October 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Sarcopenia and obesity are associated with outcomes after surgery. However, few studies have investigated which more accurately predicts postoperative complications or prognosis in patients with gastric cancer. Methods A total of 567 consecutive patients with gastric cancer who underwent gastrectomy between 2010 and 2015 were retrospectively reviewed. Psoas muscle mass index (PMI) and visceral fat area (VFA) were measured by CT scan. Patients were divided into two groups based on PMI (PMI-H group: male C 6.36 cm2/m2, female C 3.92 cm2/ m2; and PMI-L group: male \ 6.36 cm2/m2, female \ 3.92 cm2/m2) and two groups based on VFA (VFA-H group: C 100 cm2; VFA-L group: \ 100 cm2). The incidence of postoperative complications and the recurrence-free survival (RFS) were compared between the two groups. Results The incidence of postoperative complications was significantly higher in the VFA-H group than in the VFAL group (35.1% vs. 20.3%; P \ 0.001), whereas there was no significant difference between the PMI-H and PMI-L groups. Multivariate analysis showed that PMI-L and VFA-H were independent risk factors for pneumonia (odds ratio, 4.49; P = 0.018) and intra-abdominal abscess (odds ratio, 5.19; P = 0.004), respectively. While there was no significant difference in RFS between the VFA-H and VFA-L groups, the PMI-L group showed significantly worse RFS than the PMI-H group (P \ 0.001). Conclusions PMI and VFA were useful predictive factors for postoperative pneumonia and intra-abdominal abscess, respectively. PMI might be a useful prognostic factor in patients with gastric cancer, but VFA is not.
Introduction Gastric cancer remains the fifth most common malignancy and the third leading cause of cancer death worldwide [1], and various types of therapies for gastric cancer have been developed [2, 3]. Nonetheless, surgery remains the most & Yukinori Kurokawa [email protected] 1
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, Osaka, Japan
2
Department of Gastroenterological Surgery, Saiseikai Senri Hospital, Suita, Osaka, Japan
effective curative treatment for gastric cancer, and radical gastrectomy is associated with high morbidity and mortality [4, 5]. Therefore, the role of preoperative assessment has become increasingly important, and recently there has been growing interest in the relationship between sarcopenia or obesity and postoperative outcomes. Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, which leads
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