Ardito Francesco, Coppola Alessandro, Rinninella Emanuele, Razionale Francesco, Pulcini Gabriele, Carano Davide, Cintoni Marco, Mele Maria Cristina, Barbaro Brunella, Giuliante Felice
Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Clin Med. 2022 Mar 10;11(6):1530. doi: 10.3390/jcm11061530.
Background: Sarcopenia is considered a predictor of poor postoperative and long-term results following liver resection for intrahepatic cholangiocarcinoma (ICC). The aim of our study was to assess the incidence of sarcopenia in patients resected for ICC and its relation to preoperative clinical factors. Methods: Patients resected for ICC in our unit, with available preoperative CT scans within one month before operation, were enrolled in the study. Skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) were assessed for each patient. Results: Thirty patients matched all inclusion criteria. Low SMI values were documented in 15 patients (50.0%), and low SMD values were documented in 10 patients (33.3%). SMI was significantly greater in males (p < 0.001). In patients who were underweight, the incidence of low SMI was significantly higher than that of high SMI (p = 0.031). In patients who were overweight/obese, the incidence of high SMI was significantly higher than that of low SMI (p = 0.003) and the incidence of low SMD was significantly higher than that of high SMD (p = 0.038). In the univariate analysis, no preoperative factors (clinical and tumor-related factors), in particular BMI, were found to be independent predictors of low SMI. Conclusions: The incidence of sarcopenia was 50.0% in patients selected for liver resection for ICC and was not related to the preoperative clinical factors. A multidisciplinary evaluation of the nutritional status is fundamental before liver resection in patients.
肌肉减少症被认为是肝内胆管癌（ICC）肝切除术后不良预后和长期结果的预测指标。本研究的目的是评估接受ICC切除术患者的肌肉减少症发生率及其与术前临床因素的关系。方法：纳入在我院接受ICC切除术且术前1个月内有可用CT扫描的患者。评估每位患者的骨骼肌指数（SMI）和骨骼肌放射密度（SMD）。结果：30例患者符合所有纳入标准。15例患者（50.0%）记录到低SMI值，10例患者（33.3%）记录到低SMD值。男性的SMI显著更高（p < 0.001）。体重过轻的患者中，低SMI的发生率显著高于高SMI（p = 0.031）。超重/肥胖患者中，高SMI的发生率显著高于低SMI（p = 0.003），低SMD的发生率显著高于高SMD（p = 0.038）。在单因素分析中，未发现任何术前因素（临床和肿瘤相关因素），特别是BMI，是低SMI的独立预测因素。结论：接受ICC肝切除术患者的肌肉减少症发生率为50.0%，且与术前临床因素无关。对患者进行肝切除术前，多学科评估营养状况至关重要。
