Prognostic Significance of Sarcopenia and Systemic Inflammatory Markers in Biliary Tract Cancer: A Retrospective Cohort Study

Masashi Utsumi ¹, Masaru Inagaki ², Koji Kitada ²

⁰Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan. utsumi.masashi.vn@mail.hosp.go.jp.

Journal of Gastrointestinal Cancer +

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February 25, 2024

View abstract on PubMed

Summary

Sarcopenia and low prognostic nutritional index (PNI) are independent predictors of poor outcomes in biliary tract cancer (BTC) patients after surgery. Combining these factors offers better prognostic value for overall survival.

Area Of Science

Oncology
Surgical Oncology
Gastroenterology

Background

Biliary tract cancer (BTC) poses significant treatment challenges.
Identifying reliable prognostic markers is crucial for optimizing patient management after surgical resection.
Sarcopenia and systemic inflammation are increasingly recognized as important factors in cancer prognosis.

Purpose Of The Study

To investigate the prognostic significance of sarcopenia and systemic inflammatory markers in patients undergoing surgical resection for BTC.
To determine if sarcopenia and inflammatory markers independently predict overall survival (OS) and recurrence-free survival (RFS).

Main Methods

A cohort of 146 patients with surgically resected BTC was analyzed.
Sarcopenia was assessed using the psoas muscle index.
Preoperative inflammatory markers were used to calculate the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio.
Cox regression analysis identified independent prognostic factors for OS and RFS.

Main Results

Sarcopenia was present in 64 patients and associated with lower BMI, lymph node metastasis, and low PNI.
Sarcopenia, lymph node metastasis, intrahepatic cholangiocarcinoma, R1/R2 resection, and low PNI were independent predictors of OS.
Male sex, lymph node metastasis, intrahepatic cholangiocarcinoma, R1/R2 resection, poor tumor differentiation, and low PNI independently predicted RFS.
Patients with both sarcopenia and low PNI had significantly worse OS compared to other groups.

Conclusions

Sarcopenia is closely associated with the prognostic nutritional index (PNI) in BTC patients.
Both sarcopenia and PNI are independent prognostic factors for resected BTC.
Combining sarcopenia assessment with PNI evaluation may enhance prognostic accuracy for patients with BTC.

Keywords:

Biliary tract cancer Prognostic nutritional index Sarcopenia Surgical resection Systemic inflammatory marker