肌肉量低对接受食管癌手术患者的预后意义。
Prognostic significance of low muscle volume in patients undergoing surgery for oesophageal cancer.
机构信息
Cardiff University, Division of Cancer and Genetics, Cardiff, Wales, United Kingdom.
Cardiff & Vale University Health Board, Department of Surgery, Cardiff, Wales, United Kingdom.
出版信息
Clin Nutr ESPEN. 2020 Dec;40:220-225. doi: 10.1016/j.clnesp.2020.09.016. Epub 2020 Sep 29.
BACKGROUND & AIMS: This study aimed to determine the prognostic significance of low muscle volume (LMV) Bioelectrical Impedance Analysis (BIA), defined skeletal muscle index (SMI, Kg/m male ≤8.75, female ≤5.75) in patients undergoing potentially curative surgery for Oesophageal Cancer (OC).
METHODS
A prospective study of 122 patients diagnosed with OC [median age 65 yr, 104 male, 65 neoadjuvant therapy] who underwent preoperative BIA (Maltron Bioscan 920). Primary outcome measure was Overall Survival (OS).
RESULTS
LMV was identified in 11 (9.0%) of patients, which was associated with low lean muscle mass (27.3 vs. 31.1 kg, p = 0.012), low body fat (8.8 vs.19.3 kg, p < 0.001), and greater total body water (72.2 vs. 62.2%, p = 0.001), and more open & close laparotomies (36.4 vs. 8.1%, p = 0.012). Median and 5-year OS was 16 months and 18.2% in LMV patients, compared with 51 months and 52.4% in non-sarcopenic patients (p = 0.002). On multivariable analysis of pre-operative variables, only LMV (HR 2.75; 95% CI 1.33-5.66, p = 0.006) was associated with OS.
CONCLUSION
BIA is an important prognostic indicator in OC and focused pre-habilitation consequently has strong potential.
背景与目的
本研究旨在确定低肌肉量（LMV）生物电阻抗分析（BIA）的预后意义，即定义为男性骨骼肌指数（SMI，Kg/m ≤8.75，女性 ≤5.75），用于接受潜在根治性手术治疗的食管癌（OC）患者。
方法
前瞻性研究了 122 例诊断为 OC 的患者[中位年龄 65 岁，104 例男性，65 例新辅助治疗]，这些患者接受了术前 BIA（Maltron Bioscan 920）检测。主要观察指标是总生存率（OS）。
结果
11 例（9.0%）患者存在 LMV，这与低瘦肌肉量（27.3 与 31.1kg，p=0.012）、低体脂肪量（8.8 与 19.3kg，p<0.001）、更大的总体水量（72.2 与 62.2%，p=0.001）以及更多的剖腹手术（36.4 与 8.1%，p=0.012）相关。在 LMV 患者中，中位和 5 年 OS 分别为 16 个月和 18.2%，而非肌少症患者则为 51 个月和 52.4%（p=0.002）。在术前变量的多变量分析中，只有 LMV（HR 2.75；95%CI 1.33-5.66，p=0.006）与 OS 相关。
结论
BIA 是 OC 的一个重要预后指标，因此有针对性的术前康复具有很强的潜力。
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