Chan Miu Yee, Chok Kenneth Siu Ho
Department of Surgery, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.
Department of Surgery and State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.
World J Gastrointest Oncol. 2019 Jul 15;11(7):527-537. doi: 10.4251/wjgo.v11.i7.527.
Sarcopenia is found in up to 65% of pancreatic cancer patients. The definition and diagnostic methods for sarcopenia have changed over the years, and the measurement of skeletal muscle mass with cross-sectional imaging has become the most popular way of assessment, although the parameters measured vary among different studies. It is still debatable that there is an association between sarcopenia and postoperative pancreatic fistula, but most studies showed a higher risk in patients with sarcopenic obesity. Long-term survival is worse in sarcopenic patients, as shown by meta-analysis. Sarcopenia is also associated with decreased survival and higher toxicity in patients receiving chemotherapy, and chemotherapy also tends to potentiate sarcopenia. Treatment for sarcopenia still remains an area for research, although oral supplements, nutritional modifications and exercise training have been shown to improve sarcopenia.
高达65%的胰腺癌患者存在肌肉减少症。多年来，肌肉减少症的定义和诊断方法不断变化，尽管不同研究测量的参数有所不同，但利用横断面成像测量骨骼肌质量已成为最常用的评估方法。肌肉减少症与术后胰瘘之间是否存在关联仍存在争议，但大多数研究表明，肌肉减少性肥胖患者的风险更高。荟萃分析显示，肌肉减少症患者的长期生存率较差。肌肉减少症还与接受化疗患者的生存率降低和毒性增加有关，而且化疗往往会加重肌肉减少症。尽管口服补充剂、营养调整和运动训练已被证明可改善肌肉减少症，但肌肉减少症的治疗仍是一个研究领域。
