术前潜在肌肉减少症与接受大手术的癌症患者生存率之间的关联。

Association between preoperative potential sarcopenia and survival of cancer patients undergoing major surgical procedures.

作者信息

Behne Thayse Emanuelli Godoy, Dock-Nasimento Diana Borges, Sierra Jessika Cadavid, Rodrigues Hadassa Hillary Novaes Pereira, Palauro Maristela Luft, Andreo Francilene Oliveira, Silva-The Mariana Borges, DE-Aguilar-Nascimento JosÉ Eduardo

机构信息

- Universidade Federal de Mato Grosso, Programa de Pós-graduação em Ciências da Saúde, Faculdade de Ciências Médicas - Cuiabá - MT - Brasil.

- Universidade Federal de Mato Grosso, Faculdade de Nutrição - Cuiabá - MT - Brasil.

出版信息

Rev Col Bras Cir. 2020 Sep 4;47:e20202528. doi: 10.1590/0100-6991e-20202528.

DOI:10.1590/0100-6991e-20202528

PMID:32901706

Abstract

OBJECTIVE

to evaluate the impact of probable sarcopenia (PS) on the survival of oncological patients submitted to major surgeries.

METHOD

prospective cohort bicentrical study enrolling adult oncological patients submitted to major surgeries at Cancer Hospital and Santa Casa de Misericordia in Cuiabá-MT. The main endpoint was the verification of postoperative death. Demographic and clinical data was collected. PS was defined as the presence of 1) sarcopenia risk assessed by SARC-F questionnaire and 2) low muscle strength measured by dynamometry. The cumulative mortality rate was calculated for patients with either PS or non PS using Kaplan Meier curve. The univariate and multivariate Cox regression model was used to evaluate the association of mortality with various investigated confounding variables.

RESULTS

a total of 220 patients with a mean (SD) age of 58.7±14.0 years old, 60.5% males participated of the study. Patients with PS had higher risk to postoperative death (RR=5.35 95%CI 1.95-14.66; p=0,001) and for infectious complications (RR=2.45 95%CI 1.12-5.33; p=0.036). The 60 days mean survival was shorter for patients with PS: 44 (IQR=32-37) vs 58 (IQR=56-59) days (log rank <0,001). The Cox multivariate regression showed that PS was an independent risk factor (HR=5.8 95%CI 1.49-22.58; p=0.011) for mortality.

CONCLUSION

patients bearing PS submitted to major oncological surgery have less probability of short term survival and preoperative PS is an independent risk for postoperative mortality.

摘要

目的

评估可能的肌肉减少症（PS）对接受大手术的肿瘤患者生存的影响。

方法

前瞻性队列双中心研究，纳入在库亚巴 - 马托格罗索州癌症医院和圣卡塔琳娜慈善医院接受大手术的成年肿瘤患者。主要终点是术后死亡的验证。收集人口统计学和临床数据。PS定义为存在1）通过SARC - F问卷评估的肌肉减少症风险和2）通过握力计测量的低肌肉力量。使用Kaplan - Meier曲线计算PS患者和非PS患者的累积死亡率。单因素和多因素Cox回归模型用于评估死亡率与各种研究的混杂变量之间的关联。

结果

共有220例患者参与研究，平均（标准差）年龄为58.7±14.0岁，男性占60.5%。PS患者术后死亡风险更高（RR = 5.35，95%CI 1.95 - 14.66；p = 0.001），感染并发症风险更高（RR = 2.45，95%CI 1.12 - 5.33；p = 0.036）。PS患者的60天平均生存期较短：44（IQR = 32 - 37）天对58（IQR = 56 - 59）天（对数秩检验<0.001）。Cox多因素回归显示PS是死亡率的独立危险因素（HR = 5.8，95%CI 1.49 - 22.58；p = 0.011）。