Department of Anesthesiology and Pain Medicine, Laboratory for Perioperative Outcome and Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Anesthesia and Intensive Care, University Malaya Medical Centre, Petaling Jaya, Malaysia.
Ann Surg Oncol. 2022 Oct;29(11):6871-6881. doi: 10.1245/s10434-022-11944-z. Epub 2022 May 27.
The effects of specific body mass index (BMI) category and sarcopenia within each BMI category on outcomes in patients undergoing esophageal surgery with esophageal squamous cell carcinoma have not been thoroughly examined.
This study included 1141 patients. Sarcopenia was determined with a total psoas muscle cross-sectional area at the level of the third lumbar vertebra in computed tomography. The outcomes were long-term survival, including overall survival (OS) and recurrence-free survival (RFS), and postoperative complications.
The overweight and no sarcopenia group was considered as the reference. After adjusting covariates, the underweight and the normal weight and sarcopenia groups both showed worse OS (underweight group: hazard ratio [HR] 2.04, 95% confidence interval [CI] 1.33-3.13, p = 0.001; normal weight and sarcopenia group: HR 1.93, 95% CI 1.39-2.69, p < 0.001) and worse RFS (underweight group: HR 1.78, 95% CI 1.19-2.67, p = 0.005; normal weight and sarcopenia group: HR 1.70, 95% CI 1.25-2.30, p = 0.001). In addition, the underweight group (odds ratio [OR] 4.74, 95% CI 2.05-10.96, p < 0.001), the normal weight and sarcopenia group (OR 3.26, 95% CI 1.60-6.62, p = 0.001), the overweight and sarcopenia group (OR 2.54, 95% CI 1.14-5.68, p = 0.023), and the obese and no sarcopenia group (OR 2.44, 95% CI 1.14-5.22, p = 0.021) were at significantly higher risk of postoperative 30-day composite complications.
Compared with the overweight and no sarcopenia group, the underweight and the normal weight and sarcopenia groups were associated with worse short- and long-term outcomes.
特定体重指数（BMI）类别和每个 BMI 类别中的肌少症对接受食管鳞状细胞癌食管手术患者的结局的影响尚未得到充分研究。
本研究纳入了 1141 例患者。通过 CT 测量第三腰椎水平的总竖脊肌横截面积来确定肌少症。研究结果为长期生存，包括总生存期（OS）和无复发生存期（RFS）以及术后并发症。
超重且无肌少症组被视为参考。在调整协变量后，消瘦和正常体重且有肌少症组的 OS 均较差（消瘦组：风险比[HR]2.04，95%置信区间[CI]1.33-3.13，p=0.001；正常体重且有肌少症组：HR 1.93，95%CI 1.39-2.69，p<0.001）和 RFS 较差（消瘦组：HR 1.78，95%CI 1.19-2.67，p=0.005；正常体重且有肌少症组：HR 1.70，95%CI 1.25-2.30，p=0.001）。此外，消瘦组（比值比[OR]4.74，95%CI 2.05-10.96，p<0.001）、正常体重且有肌少症组（OR 3.26，95%CI 1.60-6.62，p=0.001）、超重且有肌少症组（OR 2.54，95%CI 1.14-5.68，p=0.023）和肥胖且无肌少症组（OR 2.44，95%CI 1.14-5.22，p=0.021）术后 30 天复合并发症的风险显著增加。
与超重且无肌少症组相比，消瘦和正常体重且有肌少症组的短期和长期结局更差。
