Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan.
Department of Surgery, Division of Hepato-biliary-pancreatic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan.
Langenbecks Arch Surg. 2020 Sep;405(6):757-766. doi: 10.1007/s00423-020-01973-1. Epub 2020 Aug 26.
For many kinds of cancer, body composition and immunonutritional status have been reported to influence postoperative outcome. We assessed their impact on short- and long-term outcome in patients with colorectal liver metastases who underwent 2-stage liver resections.
Short- and long-term outcomes for 47 patients with 2-stage hepatectomies were assessed retrospectively in terms of data obtained before preoperative chemotherapy, before the first hepatectomy, and before the second hepatectomy.
Although immunonutritional status and body composition did not affect short-term outcome, high intramuscular fat content before the second hepatectomy was a poor prognostic factor for overall survival (HR, 5.829; 95% CI, 1.611-21.090; p = 0.007) and for recurrence-free survival (HR, 2.787; 95% CI, 1.301-5.973; p = 0.008). Patients with high intramuscular fat before the second hepatectomy also showed shorter intervals from recurrence to treatment failure.
Intramuscular fat before the second hepatectomy is an important negative prognosticator in 2-stage liver resection for colorectal liver metastases.
对于许多癌症,身体成分和免疫营养状况已被报道会影响术后结果。我们评估了它们对接受两阶段肝切除术的结直肠癌肝转移患者的短期和长期结果的影响。
回顾性评估 47 例接受两阶段肝切除术患者的短期和长期结果,评估数据来自术前化疗前、第一次肝切除术前和第二次肝切除术前。
尽管免疫营养状况和身体成分不影响短期结果,但第二次肝切除术前的高肌内脂肪含量是总生存(HR,5.829;95%CI,1.611-21.090;p=0.007)和无复发生存(HR,2.787;95%CI,1.301-5.973;p=0.008)的不良预后因素。第二次肝切除术前肌内脂肪含量高的患者,从复发到治疗失败的间隔时间也较短。
在结直肠癌肝转移的两阶段肝切除中,第二次肝切除术前的肌内脂肪是一个重要的负预后因素。