Department of Surgery, Erasmus MC, Rotterdam, 'S Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Br J Surg. 2012 Apr;99(4):550-7. doi: 10.1002/bjs.7823. Epub 2012 Jan 13.
Recent evidence suggests that depletion of skeletal muscle mass (sarcopenia) and an increased amount of intra-abdominal fat (central obesity) influence cancer statistics. This study investigated the impact of sarcopenia and central obesity on survival in patients undergoing liver resection for colorectal liver metastases (CLM).
Diagnostic imaging from patients who had hepatic resection for CLM in one centre between 2001 and 2009, and who had assessable perioperative computed tomograms, was analysed retrospectively. Total cross-sectional areas of skeletal muscle and intra-abdominal fat, and their influence on outcome, were analysed.
Of the 196 patients included in the study, 38 (19·4 per cent) were classified as having sarcopenia. Five-year disease-free (15 per cent versus 28·5 per cent in patients without sarcopenia; P = 0·002) and overall (20 per cent versus 49·9 per cent respectively; P < 0·001) survival rates were lower for patients with sarcopenia at a median follow-up of 29 (range 1-97) months. Sarcopenia was an independent predictor of worse recurrence-free (hazard ratio (HR) 1·88, 95 per cent confidence interval 1·25 to 2·82; P = 0·002) and overall (HR 2·53, 1·60 to 4·01; P < 0·001) survival. Central obesity was associated with an increased risk of recurrence in men (P = 0·032), but not in women (P = 0·712).
Sarcopenia has a negative impact on cancer outcomes following resection of CLM.
最近的证据表明，骨骼肌量减少（肌肉减少症）和腹部内脂肪量增加（中心性肥胖）会影响癌症统计数据。本研究调查了肌肉减少症和中心性肥胖对接受结直肠癌肝转移（CLM）肝切除术患者的生存的影响。
回顾性分析了 2001 年至 2009 年期间在一个中心接受 CLM 肝切除术且可评估围手术期计算机断层扫描的患者的诊断图像。分析了骨骼肌和腹部内脂肪的总横截面积及其对结果的影响。
在纳入研究的 196 例患者中，38 例（19.4%）被归类为患有肌肉减少症。5 年无疾病生存率（15%比无肌肉减少症患者的 28.5%；P=0.002）和总生存率（20%比分别为 49.9%；P<0.001）较低肌肉减少症患者的中位随访时间为 29（1-97）个月。肌肉减少症是无复发生存（风险比（HR）1.88，95%置信区间 1.25 至 2.82；P=0.002）和总生存（HR 2.53，1.60 至 4.01；P<0.001）的独立预测因素。中心性肥胖与男性（P=0.032）而非女性（P=0.712）的复发风险增加相关。
肌肉减少症对 CLM 切除后的癌症结局有负面影响。
