Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

Abstract

Background: Sarcopenia is a prognostic factor for mortality in digestive surgery. However, the correlation between preoperative cardiopulmonary function and sarcopenia in patients undergoing hepatectomy for hepatocellular carcinoma (HCC) remains unclear. Methods: The present study investigated the impact of preoperative sarcopenia on cardiopulmonary function in 402 patients who underwent first hepatectomy for HCC between April 2005 and April 2015. The quantity and quality of skeletal muscle were evaluated using psoas muscle index (PMI) and intramuscular adipose tissue content (IMAC), respectively, as determined from preoperative computed tomography imaging. Correlations between preoperative cardiopulmonary function and sarcopenic factors (PMI and IMAC) were evaluated. Results: No significant correlations were found between left ventricular ejection fraction and the two sarcopenic factors. On the other hand, preoperative vital capacity (VC) and forced expiratory volume in 1 s (FEV₁) correlated significantly with PMI (p < 0.001 each) in males and with IMAC (p < 0.001 each) in females. Moreover, VC and FEV₁ in the preoperative low PMI (p < 0.001 each) and high IMAC (p = 0.002 and p < 0.001, respectively) groups were significantly lower than in the normal group in males. In females, VC and FEV₁ were significantly lower in the preoperative high IMAC group than in the normal group (p < 0.001 each). Conclusion: Preoperative low muscle mass in males and low muscle quality in males and females were significantly associated with pulmonary dysfunction.

Effect of Sarcopenia on Sleep Disturbance in Patients with Chronic Liver Diseases

“…To our knowledge, this is the first study demonstrating the relevance between sleep disturbance and sarcopenia in CLD patients. To clarify these clinical questions is of importance because liver disease-related sarcopenia has been gaining much caution these days due to its significant correlation with QOL and prognosis [21,22,23,24,25,26,27,28,29,30,31].…”

“…On the other hand, sarcopenia is a disease entity combining poor muscle function and diminished skeletal muscle mass (SMM), which results in frailty, cachexia, and osteoporosis [21,22,23,24,25,26,27,28,29,30,31,32]. It can also be associated with worse patient QOL, prognosis and higher health care costs in various diseases including CLDs [22,24,26].…”

Utility of the simplified measurements of muscle mass in patients with gastrointestinal and chronic liver diseases

“…In the present study, PMI was calculated using the manual trace method proposed by Vincent ver3.0. PMI has been reported to correlate with SMI using muscle mass measuring software (r = 0.57, P < 0.01) and SMI measured by BIA (r = 0.74, P < 0.01) [11][12][13] . Additionally, simple PMI is one of the simplified methods referred to in the JSH criteria.…”

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

“…Apart from that, several studies on hepatic resection have shown that risk of HCC recurrence is significantly higher in sarcopenic patients compared to those without muscle waste [69][70][71][72] . These data suggest that, with special regard to high immunosuppressive load early post-LT, sarcopenia-related depression of the…”