主要腹部癌手術におけるサルコペニア肥満の予後への影響：集団ベースの観察研究
Wing Kiu Chou1, Nadia Guidozzi1, Lorenzo Giorgi1
1Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
Background:
Sarcopenic obesity (SO), characterised by reduced muscle function alongside excess adiposity, is increasingly recognised in surgical patients. As its potential influence on perioperative risk becomes more apparent, there is a pressing need to understand whether SO affects outcomes in those undergoing major abdominal cancer surgery.
Methods:
We used UK Biobank anthropometric data (patients recruited March 2006-October 2010) linked to Hospital Episode Statistics to identify all individuals who underwent major abdominal cancer operations, with and without SO. Survival analysis and multivariate regression models were constructed to evaluate short-term mortality (at 30 and 90 days), overall survival, postoperative complications and hospital and intensive care length of stay.
Results:
Among 2908 patients who underwent major abdominal cancer surgery, 100 had SO. SO patients experienced significantly increased short-term mortality at 30 days (HR 6.44, 95% CI 2.45-16.92, p < 0.001∗) and 90 days (HR 3.61, 95% CI 1.54-8.43, p = 0.003∗). However, there was no significant association with postoperative complications (OR 0.79, 95% CI 0.3-1.69, p = 0.577) or overall survival (HR 1.20, 95% CI 0.64-1.71, p = 0.312). SO was associated with 27% longer hospital stay and 83% longer intensive care stay (Rate Ratio 1.27, 95% CI 1.07-1.53, p = 0.009∗ and 1.83, 95% CI 1.25-2.73, p = 0.001∗).
Conclusions:
SO is an independent risk factor for early postoperative mortality and prolonged hospital and intensive care stay following major abdominal cancer surgery, highlighting its importance in preoperative risk stratification and treatment.
