Harimoto Norifumi, Yoshizumi Tomoharu, Shimokawa Masahiro, Sakata Kazuhito, Kimura Kouichi, Itoh Shinji, Ikegami Toru, Ikeda Tetsuo, Shirabe Ken, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hepatol Res. 2016 Nov;46(12):1247-1255. doi: 10.1111/hepr.12674. Epub 2016 Apr 28.
The present study investigated the effect of sarcopenia on short- and long-term surgical outcomes and identified potential prognostic factors for hepatocellular carcinoma (HCC) following hepatectomy among patients 70 years of age and older.
Patient data were retrospectively collected for 296 consecutive patients who underwent hepatectomy for HCC with curative intent. Patients were assigned to two groups according to age (younger than 70 years, and 70 years and older), and the presence of sarcopenia. The clinicopathological, surgical outcome, and long-term survival data were analyzed.
Sarcopenia was present in 112 of 296 (37.8%) patients with HCC, and 35% of patients aged 70 years and older. Elderly patients had significantly lower serum albumin levels, prognostic nutrition index, percentage of liver cirrhosis, and histological intrahepatic metastasis compared with patients younger than 70 years. Overall survival and disease-free survival rates in patients with sarcopenia correlated with significantly poor prognosis in the group aged 70 years and older. Multivariate analysis revealed that sarcopenia was predictive of an unfavorable prognosis.
This retrospective analysis revealed that sarcopenia was predictive of worse overall survival and recurrence-free survival after hepatectomy in patients 70 years of age and older with HCC.
本研究调查了肌肉减少症对短期和长期手术结果的影响,并确定了70岁及以上肝细胞癌(HCC)患者肝切除术后潜在的预后因素。
回顾性收集296例连续接受根治性肝切除术治疗HCC患者的资料。根据年龄(70岁以下和70岁及以上)和肌肉减少症的存在情况将患者分为两组。分析临床病理、手术结果和长期生存数据。
296例HCC患者中有112例(37.8%)存在肌肉减少症,70岁及以上患者中这一比例为35%。与70岁以下患者相比,老年患者的血清白蛋白水平、预后营养指数、肝硬化百分比和组织学肝内转移率显著更低。肌肉减少症患者的总生存率和无病生存率与70岁及以上组的预后显著较差相关。多因素分析显示,肌肉减少症可预测不良预后。
这项回顾性分析表明,肌肉减少症可预测70岁及以上HCC患者肝切除术后较差的总生存率和无复发生存率。