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The Association of CT-Assessed Sarcopenia and Nutritional Status with Postoperative Outcomes in Pediatric Surgical
Apolonia Miążek1, Zoja Goti2, Maria Klimeczek Chrapusta3
1Student's Scientific Group of Pediatric Surgery, Jagiellonian University Medical College, Krakow, Poland, Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Insights
Pediatric oncology patients with sarcopenia experienced longer hospital stays after surgery. Muscle mass and nutrition are crucial factors impacting recovery and should be assessed preoperatively.
Area of Science:
- Pediatric Oncology
- Surgical Outcomes
- Body Composition Analysis
Background:
- Sarcopenia, traditionally linked to aging, is increasingly recognized in pediatric oncology.
- Limited research exists on sarcopenia's impact on surgical outcomes in pediatric cancer patients.
Purpose of the Study:
- To investigate the relationship between muscle mass and postoperative outcomes in pediatric oncologic patients.
- To identify potential predictors of surgical complications and recovery duration.
Main Methods:
- Retrospective analysis of 39 pediatric oncologic patients (3 months-16 years) undergoing abdominal/pelvic surgery.
- Measurement of total Psoas Muscle Area (tPMA) via CT scans.
- Calculation of tPMA percentile at L3/4 and L4/5 levels.
Main Results:
- No significant difference in surgical complication rates between sarcopenia and no-sarcopenia groups.
- Patients with sarcopenia had a significantly longer postoperative hospital stay.
- Preoperative tPMA percentile at L4/5 and serum total protein correlated with adverse events.
Conclusions:
- Muscle mass and nutritional status significantly influence the postoperative course in pediatric cancer patients.
- Prolonged hospitalization is associated with sarcopenia in this population.
- Preoperative assessment of muscle mass and nutritional status is recommended.
Abstract:
<b>Introduction:</b> Sarcopenia is traditionally associated with aging. However, it has been more frequently discussed in pediatric oncology. Yet, the research on sarcopenia and surgical outcomes in pediatric oncologic patients is quite limited.<b>Aim:</b> Our study aimed to assess the correlation between muscle mass and postoperative outcomes in this population.<b>Materials and methods:</b> We performed a retrospective data analysis of 39 pediatric oncologic patients aged 3 months to 16 years who underwent abdominal and/or pelvic surgery in our facility between 2017 and 2024. We measured the total Psoas Muscle Area (tPMA) on axial CT images and calculated the percentile of tPMA at L3/4 and L4/5 levels of the available benchmark.<b>Results:</b> The number and severity of surgical complications were similar between the sarcopenia and no-sarcopenia groups. However, the length of postoperative stay was significantly higher in the former group. Preoperative parameters best correlating with the number of postoperative adverse events were the percentile of tPMA at L4/L5 and the serum total protein concentration.<b>Discussion:</b> Previous studies on pediatric oncologic patients supported a correlation between sarcopenia and prolonged hospitalization. Moreover, other authors reported an association of sarcopenia with postoperative complications and overall survival.<b>Conclusions:</b> Our findings suggest that muscle mass and nutritional status influence the postoperative course, especially the length of hospitalization, in pediatric oncologic patients. Therefore, they should be addressed in the preoperative workup.<b>Study Significance:</b> The novelty of our study lies in its focus on sarcopenia and surgical outcomes in pediatric patients with malignancies, an area with limited research.
