Clinical impact of sarcopenia assessment in patients with liver cirrhosis

Marasco, Giovanni; Dajti, Elton; Ravaioli, Federico; Brocchi, Stefano; Rossini, Benedetta; Alemanni, Luigina Vanessa; Peta, Giuliano; Bartalena, Laura; Golfieri, Rita; Festi, Davide; Colecchia, Antonio; Renzulli, Matteo

doi:10.1080/17474124.2021.1848542

Cited by 18 publications

(14 citation statements)

References 124 publications

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“…[6][7][8][9][10][11] The presence of sarcopenia has been shown to be associated with increased risk of falls, fractures, reduced quality of life, development of acute J o u r n a l P r e -p r o o f decompensation or acute-on-chronic liver failure, and death in patients with cirrhosis. [6][7][8][9][12][13][14] The impact of sarcopenia in patients with liver cirrhosis may also be influenced by sex, severity of hepatic dysfunction, and etiology of cirrhosis. [10][11][12][13]15,16 Between 2016 and 2019, three meta-analyses evaluating the effect of muscle mass or sarcopenia on the survival in patients with liver cirrhosis and waiting list for liver transplantation (LT) were published.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9][12][13][14] The impact of sarcopenia in patients with liver cirrhosis may also be influenced by sex, severity of hepatic dysfunction, and etiology of cirrhosis. [10][11][12][13]15,16 Between 2016 and 2019, three meta-analyses evaluating the effect of muscle mass or sarcopenia on the survival in patients with liver cirrhosis and waiting list for liver transplantation (LT) were published. [17][18][19] However, since then, newer data from several large and rigorously designed studies with long-term follow-up became available.…”

Section: Introductionmentioning

confidence: 99%

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Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis

Tantai

Liu

Yeo

et al. 2022

Journal of Hepatology

185

126

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis

Tantai

Liu

Yeo

et al. 2022

Journal of Hepatology

185

126

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“…Moreover, this method to assess sarcopenia was evaluated in patients with liver disease and HCC [ 12 , 21 , 45 , 46 ]. As abovementioned, cross imaging analysis allows easy quantification of sarcopenia in cirrhotic patients.…”

Section: Resultsmentioning

confidence: 99%

Imaging Software-Based Sarcopenia Assessment in Gastroenterology: Evolution and Clinical Meaning

Marasco

Sadalla

Vara

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Sarcopenia is gaining attention as a negative prognostic factor in different fields of medicine, including chronic liver failure. However, the assessment of sarcopenia in patients with liver diseases is often neglected due to unawareness of reliable tools and methods and thus is limited to research studies. Cross-sectional imaging is a diffuse diagnostic tool and is commonly performed in patients with chronic liver failure. The last advancements in radiology image analysis using dedicated software allow an easy and standardized method to assess skeletal muscle volume. Several measures can be obtained from cross-sectional imaging analysis to evaluate sarcopenia in patients affected by chronic liver disease. We aimed to review the recent advances in imaging-based sarcopenia assessment, in particular in patients with chronic liver diseases. As a result, we found that the skeletal muscle index (SMI) seems to be a reliable method to assess sarcopenia in cirrhotic patients. Even if further studies are needed to validate proper cut-offs for each clinical endpoint, physicians are invited to consider the assessment of sarcopenia in the work-up of patients with chronic liver disease.

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“…However, the available tools for PHLF prediction do not assess the general, nutritional, and functional status of HCC patients. A recent field of interest in hepatology is the evaluation of the nutritional and functional status of patients mirrored by the assessment of sarcopenia [17,18]. Sarcopenia, described as a loss of skeletal muscle mass, function and strength, is the result of major metabolic changes often observed not only in oncologic settings or in the elderly, but even in advanced liver disease [17].…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis

Marasco

Dajti

Serenari

et al. 2022

Cancers

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The burden of post-operative complications of patients undergoing liver resection for hepatocellular carcinoma (HCC) is a cause of morbidity and mortality. Recently, sarcopenia has been reported to influence the outcome of patients with cirrhosis. We aimed to assess factors associated with sarcopenia and its prognostic role in liver surgery candidates. We included all patients with compensated advanced chronic liver disease (cACLD) undergoing liver resection for primary HCC consecutively referred to the University of Bologna from 2014 to 2019 with an available preoperative abdominal CT-scan performed within the previous three months. A total of 159 patients were included. The median age was 68 years, and 80.5% of the patients were male. Sarcopenia was present in 82 patients (51.6%). Age and body mass index (BMI) were associated with the presence of sarcopenia at multivariate analysis. Thirteen (8.2%) patients developed major complications and 14 (8.9%) presented PHLF grade B-C. The model for end-stage liver disease score was associated with the development of major complications, whereas cACLD presence, thrombocytopenia, portal hypertension (PH), Child-Pugh score and Albumin-Bilirubin score were found to be predictors of clinically significative PHLF. The rate of major complications was 11.8% in sarcopenic patients with cACLD compared with no complications (0%) in patients without sarcopenia and cACLD (p = 0.032). The rate of major complications was significantly higher in patients with (16.3%) vs. patients without (0%) sarcopenia (p = 0.012) in patients with PH. In conclusion, sarcopenia, which is associated with age and BMI, may improve the risk stratification of post-hepatectomy major complications in patients with cACLD and PH.

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Clinical impact of sarcopenia assessment in patients with liver cirrhosis

Cited by 18 publications

References 124 publications

Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis

Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis

Imaging Software-Based Sarcopenia Assessment in Gastroenterology: Evolution and Clinical Meaning

Sarcopenia Predicts Major Complications after Resection for Primary Hepatocellular Carcinoma in Compensated Cirrhosis

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