Department of Surgery, Research in Surgical Outcomes and Effectiveness Center (UH-RISES), University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
J Surg Oncol. 2020 Jun;121(7):1148-1153. doi: 10.1002/jso.25887. Epub 2020 Mar 4.
Sarcopenia is associated with poor long-term outcomes in many gastrointestinal cancers, but its role in anal squamous cell carcinoma (ASCC) is not defined. We hypothesized that patients with sarcopenic ASCC experience worse long-term outcomes.
A retrospective review of patients with ASCC treated at an academic medical center from 2006 to 2017 was performed. Of 104 patients with ASCC, 64 underwent PET/computed tomography before chemoradiation and were included in the analysis. The skeletal muscle index was calculated as total L3 skeletal muscle divided by height squared. Sarcopenia thresholds were 52.4 cm /m for men and 38.5 cm /m for women. Cox regression analysis was performed to assess overall and progression-free survival.
Twenty-five percent of the patients were sarcopenic (n = 16). Demographics were similar between groups. There was no difference in the clinical stage or comorbidities between groups. On multivariate analysis, factors associated with worse overall survival were male gender (hazard ratio [HR] 3.7, P = .022) and sarcopenia (HR 3.6, P = .019). Male gender was associated with worse progression-free survival (HR 2.6, P = .016).
Sarcopenia is associated with worse overall survival in patients with anal cancer. Further studies are indicated to determine if survival can be improved with increased attention to nutritional status in sarcopenic patients.
在许多胃肠道癌症中，肌肉减少症与不良的长期预后相关，但在肛门鳞状细胞癌（ASCC）中的作用尚未确定。我们假设患有肌肉减少症的 ASCC 患者的长期预后更差。
回顾性分析了 2006 年至 2017 年在学术医疗中心治疗的 ASCC 患者。在 104 例 ASCC 患者中，有 64 例在放化疗前接受了 PET/CT 检查，并纳入了分析。骨骼肌指数的计算方法为 L3 总骨骼肌除以身高的平方。男性的肌肉减少症阈值为 52.4cm/m，女性为 38.5cm/m。进行 Cox 回归分析以评估总生存期和无进展生存期。
25%的患者存在肌肉减少症（n=16）。两组的人口统计学特征相似。两组之间的临床分期和合并症无差异。多因素分析显示，总生存期较差的相关因素为男性（风险比[HR]3.7，P=.022）和肌肉减少症（HR 3.6，P=.019）。男性与无进展生存期较差相关（HR 2.6，P=.016）。
肌肉减少症与肛门癌患者的总生存期较差相关。需要进一步研究以确定是否可以通过增加对肌肉减少症患者营养状况的关注来改善生存。
