Prognostic impact of preoperative cachexia in patients undergoing major hepatopancreatobiliary surgery for malignancy
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View abstract on PubMed
Summary
This summary is machine-generated.Preoperative cachexia in hepatopancreatobiliary cancer patients did not increase short-term surgical complications. However, it significantly worsened long-term survival and disease-free survival after major surgery.
Area Of Science
- Oncology
- Surgical Oncology
- Gastroenterology
Background
- Limited data exist on cachexia's impact on clinical outcomes in hepatopancreatobiliary (HPB) malignancies.
- Cachexia is a complex multifactorial syndrome characterized by anorexia and/or inflammation-induced skeletal muscle loss.
Purpose Of The Study
- To investigate the prognostic significance of preoperative cachexia in patients undergoing major HPB surgery for malignancies.
- To evaluate the association between preoperative cachexia and postoperative overall survival (OS), disease-free survival (DFS), and complications.
Main Methods
- Retrospective review of 332 patients undergoing major open HPB surgery for malignancies (March 2014 - December 2018).
- Cachexia defined by modified Asian Working Group criteria: low BMI (<21 kg/m²), low handgrip strength, and/or elevated C-reactive protein (>0.5 mg/dL).
- Primary endpoint: postoperative OS; secondary endpoints: DFS and complications.
Main Results
- 28% of patients (93/332) had preoperative cachexia.
- Cachexia was significantly associated with shorter OS (aHR 1.65; P=0.004) and DFS (aHR 1.39; P=0.043) after adjusting for covariates.
- Cachexia significantly shortened OS in patients with pathological stage ≤II disease (aHR 2.45; P=0.008).
- No significant differences in major postoperative complications were observed between cachectic and non-cachectic groups (P=0.329).
Conclusions
- Preoperative cachexia does not impact short-term surgical complications in HPB malignancy patients.
- Preoperative cachexia is a significant negative prognostic factor for long-term survival and disease recurrence in patients undergoing major HPB surgery.
- Further research may explore interventions to mitigate cachexia's adverse effects on outcomes.
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