Preoperative Assessment of Skeletal Muscle Mass and Muscle Quality Using Computed Tomography: Incidence of Sarcopenia in Patients with Intrahepatic Cholangiocarcinoma Selected for Liver Resection

Abstract

Background: Sarcopenia is considered a predictor of poor postoperative and long-term results following liver resection for intrahepatic cholangiocarcinoma (ICC). The aim of our study was to assess the incidence of sarcopenia in patients resected for ICC and its relation to preoperative clinical factors. Methods: Patients resected for ICC in our unit, with available preoperative CT scans within one month before operation, were enrolled in the study. Skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) were assessed for each patient. Results: Thirty patients matched all inclusion criteria. Low SMI values were documented in 15 patients (50.0%), and low SMD values were documented in 10 patients (33.3%). SMI was significantly greater in males (p < 0.001). In patients who were underweight, the incidence of low SMI was significantly higher than that of high SMI (p = 0.031). In patients who were overweight/obese, the incidence of high SMI was significantly higher than that of low SMI (p = 0.003) and the incidence of low SMD was significantly higher than that of high SMD (p = 0.038). In the univariate analysis, no preoperative factors (clinical and tumor-related factors), in particular BMI, were found to be independent predictors of low SMI. Conclusions: The incidence of sarcopenia was 50.0% in patients selected for liver resection for ICC and was not related to the preoperative clinical factors. A multidisciplinary evaluation of the nutritional status is fundamental before liver resection in patients.

Prevalence and predictive value of sarcopenia in surgically treated cholangiocarcinoma: a comprehensive review and meta-analysis

“…After full-text screening, 25 studies were eliminated either due to non-compliance with inclusion criteria or due to unavailability of data. Ultimately, 33 article ( 21 – 53 ) were included in the meta-analysis ( Figure 1 ).…”

Secular trends of intrahepatic cholangiocarcinoma in a high endemic area: A population-based study

“…A previous study found the incidence of sarcopenia among ICC patients following receipt of liver resection to be 50%. Preoperative nutritional evaluation is important for ICC[ 41 ]. In addition, nutritional factors may affect the disease incidence.…”

Preoperative controlling nutritional status (CONUT) score is an independent prognostic factor in cholangiocarcinoma patients treated with hepatectomy

“…Malnutrition negatively affects patient recovery after surgery, increases health care costs, and is associated with shorter survival in cholangiocarcinoma [ 9 , 10 ]. It has been observed that approximately 32% of patients diagnosed with malnutrition at the time of admission for surgery [ [11] , [12] , [13] , [14] ]. Additionally, preoperative malnutrition has been significantly linked to postoperative liver failure and poor surgical outcomes [ 15 , 16 ].…”