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Association of Sarcopenia and Body Composition With Short-term Outcomes After Liver Resection for Malignant Tumors
Giammauro Berardi1, Giulio Antonelli2, Marco Colasanti1
1Department of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy.
JAMA Surgery
|September 23, 2020
Summary
Sarcopenia, characterized by reduced muscle mass and strength, significantly increases 90-day morbidity and hospital stay after liver resection for malignant tumors. Early assessment of sarcopenia is crucial for patient risk stratification and improved outcomes.
Area of Science:
- Hepatobiliary surgery
- Sarcopenia research
- Oncology
Background:
- Sarcopenia is linked to poor outcomes after liver resection for malignant tumors.
- Existing evidence is limited by small retrospective studies and inconsistent sarcopenia measurements.
Purpose of the Study:
- To investigate sarcopenia as a risk factor for 90-day morbidity following liver resection in cancer patients.
- To assess the impact of sarcopenia on postoperative outcomes.
Main Methods:
- A cohort study of 234 patients undergoing liver resection for malignant tumors.
- Muscle mass assessed via skeletal muscle index (SMI) on CT scans.
- Muscle strength evaluated using handgrip strength tests.
- Patients categorized into four groups based on muscle mass and strength.
Main Results:
- Patients with both reduced muscle mass and strength (Group D) exhibited significantly higher 90-day morbidity (51.5%) compared to other groups.
- Group D also experienced longer hospital stays and higher readmission rates.
- Sarcopenia, portal hypertension, liver cirrhosis, and biliary reconstruction were identified as independent risk factors for 90-day morbidity.
Conclusions:
- Sarcopenia is associated with adverse postoperative outcomes after liver resection for malignant tumors.
- Preoperative assessment of both muscle mass (SMI) and strength (handgrip) is recommended for risk stratification.
- Early identification of sarcopenia can help minimize patient morbidity.
