Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis

Peter D. Peng, Mark G. Van Vledder, Susan Tsai, Mechteld C. De Jong, Martin Makary, Julie Ng, Barish H. Edil, Christopher L. Wolfgang, Richard D. Schulick, Michael A. Choti, Ihab Kamel, Timothy M. Pawlik

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Abstract

Background: As indications for liver resection expand, objective measures to assess the risk of peri-operative morbidity are needed. The impact of sarcopenia on patients undergoing liver resection for colorectal liver metastasis (CRLM) was investigated. Methods: Sarcopenia was assessed in 259 patients undergoing liver resection for CRLM by measuring total psoas area (TPA) on computed tomography (CT). The impact of sarcopenia was assessed after controlling for clinicopathological factors using multivariate modelling. Results: Median patient age was 58 years and most patients (60%) were male. Forty-one (16%) patients had sarcopenia (TPA ≤ 500 mm). Post-operatively, 60 patients had a complication for an overall morbidity of 23%; 26 patients (10%) had a major complication (Clavien grade a). The presence of sarcopenia was strongly associated with an increased risk of major post-operative complications [odds ratio (OR) 3.33; P= 0.008]. Patients with sarcopenia had longer hospital stays (6.6 vs. 5.4 days; P= 0.03) and a higher chance of an extended intensive care unit (ICU) stay (>2 days; P= 0.004). On multivariate analysis, sarcopenia remained independently associated with an increased risk of post-operative complications (OR 3.12; P= 0.02). Sarcopenia was not significantly associated with recurrence-free [hazard ratio (HR) = 1.07] or overall (HR = 1.05) survival (both P > 0.05). Conclusions: Sarcopenia impacts short-, but not long-term outcomes after resection of CRLM. While patients with sarcopenia are at an increased risk of post-operative morbidity and longer hospital stay, long-term survival is not impacted by the presence of sarcopenia.

Original languageEnglish (US)
Pages (from-to)439-446
Number of pages8
JournalHPB
Volume13
Issue number7
DOIs
StatePublished - Jul 2011

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Sarcopenia
Neoplasm Metastasis
Liver
Morbidity
Length of Stay
Odds Ratio
Survival
Intensive Care Units
Multivariate Analysis

Keywords

  • colorectal cancer
  • frailty
  • liver
  • metastasis
  • resection
  • sarcopenia

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Peng, P. D., Van Vledder, M. G., Tsai, S., De Jong, M. C., Makary, M., Ng, J., ... Pawlik, T. M. (2011). Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis. HPB, 13(7), 439-446. https://doi.org/10.1111/j.1477-2574.2011.00301.x

Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis. / Peng, Peter D.; Van Vledder, Mark G.; Tsai, Susan; De Jong, Mechteld C.; Makary, Martin; Ng, Julie; Edil, Barish H.; Wolfgang, Christopher L.; Schulick, Richard D.; Choti, Michael A.; Kamel, Ihab; Pawlik, Timothy M.

In: HPB, Vol. 13, No. 7, 07.2011, p. 439-446.

Research output: Contribution to journalArticle

Peng, PD, Van Vledder, MG, Tsai, S, De Jong, MC, Makary, M, Ng, J, Edil, BH, Wolfgang, CL, Schulick, RD, Choti, MA, Kamel, I & Pawlik, TM 2011, 'Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis', HPB, vol. 13, no. 7, pp. 439-446. https://doi.org/10.1111/j.1477-2574.2011.00301.x
Peng, Peter D. ; Van Vledder, Mark G. ; Tsai, Susan ; De Jong, Mechteld C. ; Makary, Martin ; Ng, Julie ; Edil, Barish H. ; Wolfgang, Christopher L. ; Schulick, Richard D. ; Choti, Michael A. ; Kamel, Ihab ; Pawlik, Timothy M. / Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis. In: HPB. 2011 ; Vol. 13, No. 7. pp. 439-446.
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abstract = "Background: As indications for liver resection expand, objective measures to assess the risk of peri-operative morbidity are needed. The impact of sarcopenia on patients undergoing liver resection for colorectal liver metastasis (CRLM) was investigated. Methods: Sarcopenia was assessed in 259 patients undergoing liver resection for CRLM by measuring total psoas area (TPA) on computed tomography (CT). The impact of sarcopenia was assessed after controlling for clinicopathological factors using multivariate modelling. Results: Median patient age was 58 years and most patients (60{\%}) were male. Forty-one (16{\%}) patients had sarcopenia (TPA ≤ 500 mm). Post-operatively, 60 patients had a complication for an overall morbidity of 23{\%}; 26 patients (10{\%}) had a major complication (Clavien grade a). The presence of sarcopenia was strongly associated with an increased risk of major post-operative complications [odds ratio (OR) 3.33; P= 0.008]. Patients with sarcopenia had longer hospital stays (6.6 vs. 5.4 days; P= 0.03) and a higher chance of an extended intensive care unit (ICU) stay (>2 days; P= 0.004). On multivariate analysis, sarcopenia remained independently associated with an increased risk of post-operative complications (OR 3.12; P= 0.02). Sarcopenia was not significantly associated with recurrence-free [hazard ratio (HR) = 1.07] or overall (HR = 1.05) survival (both P > 0.05). Conclusions: Sarcopenia impacts short-, but not long-term outcomes after resection of CRLM. While patients with sarcopenia are at an increased risk of post-operative morbidity and longer hospital stay, long-term survival is not impacted by the presence of sarcopenia.",
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AU - Peng, Peter D.

AU - Van Vledder, Mark G.

AU - Tsai, Susan

AU - De Jong, Mechteld C.

AU - Makary, Martin

AU - Ng, Julie

AU - Edil, Barish H.

AU - Wolfgang, Christopher L.

AU - Schulick, Richard D.

AU - Choti, Michael A.

AU - Kamel, Ihab

AU - Pawlik, Timothy M.

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N2 - Background: As indications for liver resection expand, objective measures to assess the risk of peri-operative morbidity are needed. The impact of sarcopenia on patients undergoing liver resection for colorectal liver metastasis (CRLM) was investigated. Methods: Sarcopenia was assessed in 259 patients undergoing liver resection for CRLM by measuring total psoas area (TPA) on computed tomography (CT). The impact of sarcopenia was assessed after controlling for clinicopathological factors using multivariate modelling. Results: Median patient age was 58 years and most patients (60%) were male. Forty-one (16%) patients had sarcopenia (TPA ≤ 500 mm). Post-operatively, 60 patients had a complication for an overall morbidity of 23%; 26 patients (10%) had a major complication (Clavien grade a). The presence of sarcopenia was strongly associated with an increased risk of major post-operative complications [odds ratio (OR) 3.33; P= 0.008]. Patients with sarcopenia had longer hospital stays (6.6 vs. 5.4 days; P= 0.03) and a higher chance of an extended intensive care unit (ICU) stay (>2 days; P= 0.004). On multivariate analysis, sarcopenia remained independently associated with an increased risk of post-operative complications (OR 3.12; P= 0.02). Sarcopenia was not significantly associated with recurrence-free [hazard ratio (HR) = 1.07] or overall (HR = 1.05) survival (both P > 0.05). Conclusions: Sarcopenia impacts short-, but not long-term outcomes after resection of CRLM. While patients with sarcopenia are at an increased risk of post-operative morbidity and longer hospital stay, long-term survival is not impacted by the presence of sarcopenia.

AB - Background: As indications for liver resection expand, objective measures to assess the risk of peri-operative morbidity are needed. The impact of sarcopenia on patients undergoing liver resection for colorectal liver metastasis (CRLM) was investigated. Methods: Sarcopenia was assessed in 259 patients undergoing liver resection for CRLM by measuring total psoas area (TPA) on computed tomography (CT). The impact of sarcopenia was assessed after controlling for clinicopathological factors using multivariate modelling. Results: Median patient age was 58 years and most patients (60%) were male. Forty-one (16%) patients had sarcopenia (TPA ≤ 500 mm). Post-operatively, 60 patients had a complication for an overall morbidity of 23%; 26 patients (10%) had a major complication (Clavien grade a). The presence of sarcopenia was strongly associated with an increased risk of major post-operative complications [odds ratio (OR) 3.33; P= 0.008]. Patients with sarcopenia had longer hospital stays (6.6 vs. 5.4 days; P= 0.03) and a higher chance of an extended intensive care unit (ICU) stay (>2 days; P= 0.004). On multivariate analysis, sarcopenia remained independently associated with an increased risk of post-operative complications (OR 3.12; P= 0.02). Sarcopenia was not significantly associated with recurrence-free [hazard ratio (HR) = 1.07] or overall (HR = 1.05) survival (both P > 0.05). Conclusions: Sarcopenia impacts short-, but not long-term outcomes after resection of CRLM. While patients with sarcopenia are at an increased risk of post-operative morbidity and longer hospital stay, long-term survival is not impacted by the presence of sarcopenia.

KW - colorectal cancer

KW - frailty

KW - liver

KW - metastasis

KW - resection

KW - sarcopenia

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