Furukawa Kenei, Haruki Koichiro, Taniai Tomohiko, Hamura Ryoga, Shirai Yoshihiro, Yasuda Jungo, Shiozaki Hironori, Onda Shinji, Gocho Takeshi, Ikegami Toru
Division of Hepatobiliary and Pancreas Surgery Department of Surgery The Jikei University School of Medicine Minato-ku Japan.
Ann Gastroenterol Surg. 2021 Jan 18;5(3):390-398. doi: 10.1002/ags3.12428. eCollection 2021 May.
We investigated the prognostic impact of osteosarcopenia, which is the combination of osteopenia and sarcopenia, in patients with colorectal liver metastases (CRLM) after hepatic resection.
One hundred and eighteen patients were analyzed retrospectively. Osteopenia was evaluated with computed tomographic measurement of pixel density in the midvertebral core of the 11th thoracic vertebra. Sarcopenia was evaluated with psoas muscle areas at the third lumbar vertebra. Osteosarcopenia was defined as the concomitant occurrence of osteopenia and sarcopenia.
Osteosarcopenia was identified in 38 (32%) of the patients. In univariate analysis, the overall survival was significantly worse in patients with lymph node metastases ( = .01), extrahepatic lesion ( = .01), sarcopenia ( = .02), osteosarcopenia ( < .01), Glasgow Prognostic Score (GPS) 1 or 2 ( = .05), and curability R 1 or 2 ( = .04). In multivariate analysis, lymph node metastases ( < .01), osteosarcopenia ( < .01), and GPS 1 or 2 ( = .03) were independent and significant predictors of the overall survival. In patients with osteosarcopenia, there were more women than men and body mass index was lower compared to patients without osteosarcopenia.
Osteosarcopenia was the strong predictor for outcomes in patients who underwent liver resection for CRLM.
我们研究了骨少肌少症(即骨质减少和肌肉减少症并存)对结直肠癌肝转移(CRLM)患者肝切除术后预后的影响。
对118例患者进行回顾性分析。通过计算机断层扫描测量第11胸椎椎体中部核心区域的像素密度来评估骨质减少情况。通过测量第三腰椎水平的腰大肌面积来评估肌肉减少症。骨少肌少症定义为骨质减少和肌肉减少症同时存在。
38例(32%)患者被诊断为骨少肌少症。单因素分析显示,有淋巴结转移(P = 0.01)、肝外病变(P = 0.01)、肌肉减少症(P = 0.02)、骨少肌少症(P < 0.01)、格拉斯哥预后评分(GPS)为1或2(P = 0.05)以及根治性切除为R1或R2(P = 0.04)的患者总生存期明显更差。多因素分析显示,淋巴结转移(P < 0.01)、骨少肌少症(P < 0.01)和GPS为1或2(P = 0.03)是总生存期的独立且显著的预测因素。骨少肌少症患者中女性多于男性,且与无骨少肌少症患者相比,体重指数更低。
骨少肌少症是CRLM患者肝切除术后预后的有力预测指标。