Prognostic value of muscle depletion assessed by computed tomography for surgical outcomes of cancer patients undergoing total esophagectomy and gastrectomy

Abstract

Introduction Considering the high morbimortality rate in oncologic surgeries of the gastrointestinal tract, especially in patients with malnutrition, the use of predictive tools is necessary, since preoperative strategies could improve postoperative outcomes. Objectives To evaluate body composition by computed tomography and its association with morbimortality post esophagectomy and total gastrectomy. Methods Prospective cohort study (n = 80). Sociodemographic, diagnostic, treatment and postoperative data were collected. Anthropometric and biochemical (hemoglobin, transferrin, and albumin) data were evaluated. The muscle mass was calculated through two methods, the muscle mass index (MMI) and the psoas total area (PTA). For postoperative complications classification, the Clavien‐Dindo scale was used. Results The prevalence of muscle depletion found was 33.8% by MMI and 61% by PTA (poor agreement, kappa = 0.25). Complication rates were 18.5% in gastrectomies and 50% in esophagectomies. No statistically significant difference was found between the presence of muscle depletion and complications. However, when stratified by surgery, a borderline association was found between the MMI and post esophagectomies complications (P = .05). Conclusion Despite the high prevalence of muscle loss, it was not possible to correlate it with surgical outcomes for gastrectomies, but for esophagectomies, there may be relevance due to borderline association, although patients received nutritional therapy.

Assessment of the Physical Invasiveness of Peroral Endoscopic Myotomy during the Perioperative Period Based on Changes in Energy Metabolism

“…In this study, we found that the myotomy length was associated with changes in energy metabolism during the perioperative period of POEM. Previous reports have discussed the prognostic and risk factors for complications of ESD and other surgical procedures [ 59 , 60 , 61 ]. Age [ 62 , 63 ], body mass index (BMI) [ 64 , 65 ], surgical duration [ 66 ], resection area [ 32 ], and nutritional status [ 67 , 68 ] are commonly reported factors.…”

Psoas muscle mass, nutritional status, inflammation, and their relationship with prognosis in patients with pancreatic adenocarcinoma

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