Impact of preoperative quality as well as quantity of skeletal muscle on survival after resection of pancreatic cancer

Okumura, Shinya; Kaido, Toshimi; Hamaguchi, Yuhei; Fujimoto, Yasuhiro; Masui, Toshihiko; Mizumoto, Masaki; Hammad, Ahmed; Mori, Akira; Takaori, Kyoichi; Üemoto, Shinji

doi:10.1016/j.surg.2015.02.002

Cited by 236 publications

(250 citation statements)

References 26 publications

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“…Although in some studies a correlation between PA and post‐operative complications was seen, the majority have failed to prove a relationship between PA‐assessed sarcopenia and survival 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23. Only few have actually assessed the agreement between PA and SMA within their population; Jones et al studied 100 patients with colorectal cancer and reported a Spearman correlation of 0.8 for PA and SMA and a Spearman correlation of 0.94 for PA and PLW, which could not be reproduced in our cohort 11.…”

Section: Discussionmentioning

confidence: 99%

“…PA has shown a correlation with post‐operative complications in individual studies on colorectal cancer, colorectal liver metastases, kidney cancer, bladder cancer, cholangiocarcinoma, and hepatocellular cancer,11, 12, 13, 14, 15, 16 while this effect was not seen in other pancreatic cancer, endometrial cancer, biliary cancer, or sarcoma studies 17, 18, 19, 20. Interestingly, only few cancer studies were able to show a correlation between PA and survival 21, 22, 23. In a small number of non‐cancer studies, decreased psoas muscle area has also been correlated with higher rates of morbidity24, 25, 26 and mortality25, 27, 28, 29 in patients undergoing cardiothoracic, gastro‐intestinal, and spinal surgery.…”

Section: Introductionmentioning

confidence: 99%

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Psoas muscle area is not representative of total skeletal muscle area in the assessment of sarcopenia in ovarian cancer

Rutten

Ubachs

Kruitwagen

et al. 2017

J cachexia sarcopenia muscle

161

146

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BackgroundComputed tomography measurements of total skeletal muscle area can detect changes and predict overall survival (OS) in patients with advanced ovarian cancer. This study investigates whether assessment of psoas muscle area reflects total muscle area and can be used to assess sarcopenia in ovarian cancer patients.MethodsOvarian cancer patients (n = 150) treated with induction chemotherapy and interval debulking were enrolled retrospectively in this longitudinal study. Muscle was measured cross sectionally with computed tomography in three ways: (i) software quantification of total skeletal muscle area (SMA); (ii) software quantification of psoas muscle area (PA); and (iii) manual measurement of length and width of the psoas muscle to derive the psoas surface area (PLW). Pearson correlation between the different methods was studied. Patients were divided into two groups based on the extent of change in muscle area, and agreement was measured with kappa coefficients. Cox‐regression was used to test predictors for OS.ResultsCorrelation between SMA and both psoas muscle area measurements was poor (r = 0.52 and 0.39 for PA and PLW, respectively). After categorizing patients into muscle loss or gain, kappa agreement was also poor for all comparisons (all κ < 0.40). In regression analysis, SMA loss was predictive of poor OS (hazard ratio 1.698 (95%CI 1.038–2.778), P = 0.035). No relationship with OS was seen for PA or PLW loss.ConclusionsChange in psoas muscle area is not representative of total muscle area change and should not be used to substitute total skeletal muscle to predict survival in patients with ovarian cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psoas muscle area is not representative of total skeletal muscle area in the assessment of sarcopenia in ovarian cancer

Rutten

Ubachs

Kruitwagen

et al. 2017

J cachexia sarcopenia muscle

161

146

View full text Add to dashboard Cite

show abstract

“…Cross-sectional areas (cm 2 ) of these muscles were measured by manual tracing on the CT images, and their sum was calculated. These sums were normalized for each patient to provide a psoas muscle index value (PMI; cm 2 /m 2 ) (33,34). The median PMI value was calculated for males and females separately.…”

Section: Patients and Indications For Systemic Chemotherapymentioning

confidence: 99%

“…PC was diagnosed primarily based on the current guidelines (35). Briefly, abdominal US and dynamic CT of the pancreas was routinely performed prior to initiating systemic chemotherapy (33). In cases with atypical radiological findings for PC, tumor biopsy or EUS-guided fine needle aspiration was considered (36).…”

Section: Patients and Indications For Systemic Chemotherapymentioning

confidence: 99%

Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

et al. 2017

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Abstract. To the best of our knowledge, there are few previous studies that have investigated the effect of decreased skeletal muscle mass (DSMM) on survival in patients with unresectable advanced pancreatic cancer (APC) who are undergoing systemic chemotherapy. Thus, the present study aimed to investigate the impact of DSMM, as determined by the psoas muscle index (PMI) following computed tomography and prior to systemic chemotherapy, on the outcomes of patients with unresectable APC (n=61). The primary endpoint used was the overall survival (OS) rate. The OS rates in the PMI-High group (exceeds the median PMI value in each gender) were retrospectively compared with those in the PMI-Low group (below the median PMI value in each gender), and factors associated with OS were investigated using univariate and multivariate analyses. The study cohort included 31 male and 30 female patients with a median age of 72 years, 13 of whom were stage IVA, and 48 were stage IVB. ). The proportion of patients with performance status 0 in the PMI-High group was significantly high, compared with that in the PMI-Low group [83.3% (25/30) vs. 58.1% (18/31); P=0.0486]. Body mass index in the PMI-High group was significantly higher compared with that in the PMI-Low group (P=0.0154). The 1-year cumulative survival rate was 43.3% in the PMI-High group and 12.9% in the PMI-Low group (P=0.0027). Following multivariate analysis, PMI (P=0.0036), prothrombin time (P=0.0044) and carbohydrate antigen 19-9 (P= 0.0451) were identified to be significant predictors of OS. In conclusion, DSMM, as determined by the PMI, could be a significant predictor of prognosis in patients with unresectable APC who are receiving systemic chemotherapy.

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“…In addition to LT, we recently reported the significance of preoperative low quality as well as quantity of skeletal muscle in patients who underwent surgery for hepatocellular carcinoma, intrahepatic cholangiocarcinoma, biliary cancer, and pancreatic cancer (12)(13)(14)(15). In these cancers, low skeletal muscle mass and muscle quality are closely involved with impaired outcomes.…”

Section: To the Editormentioning

confidence: 99%

Sarcopenia plays a crucial role in liver transplantation

Kaido

Hamaguchi

Üemoto

2017

Hepatobiliary Surg. Nutr.

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Impact of preoperative quality as well as quantity of skeletal muscle on survival after resection of pancreatic cancer

Abstract: Preoperative sarcopenia, indicating low quality and quantity of skeletal muscle, is closely related to mortality after resection of pancreatic cancer.

Cited by 236 publications

References 26 publications

Psoas muscle area is not representative of total skeletal muscle area in the assessment of sarcopenia in ovarian cancer

Psoas muscle area is not representative of total skeletal muscle area in the assessment of sarcopenia in ovarian cancer

Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

Sarcopenia plays a crucial role in liver transplantation

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