Division of Gastroenterological and General Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
World J Surg Oncol. 2022 Jun 2;20(1):176. doi: 10.1186/s12957-022-02627-w.
This study aimed to investigate whether preoperative muscle mass is associated with the recurrence of distal cholangiocarcinoma after pancreatoduodenectomy (PD).
We retrospectively examined 88 patients who had undergone PD for distal cholangiocarcinoma. The preoperative psoas muscle mass index (PMI) was measured using computed tomography as an index of muscle mass. We performed multivariate analysis of factors influencing early recurrence and developed a prognostic survival model using independent risk factors for recurrence.
The cut-off PMI values for recurrence within 1 year of surgery, determined from the receiver operating characteristic curve, were 5.90 cm/m in males and 3.98 cm/m in females. Multivariate analysis of effects associated with early recurrence within 1 year indicated that low PMI (odds ratio [OR] 9.322; 95% confidence interval [CI] 2.832 - 30.678; p = 0.0002) and lymph node metastasis (OR 5.474; 95% CI 1.620 - 18.497; p = 0.0062) were independent risk factors, and the median recurrence-free survival (RFS) of the low and high PMI groups were 21.6 and 81.0 months, respectively (p = 0.0214). The median RFS for zero, one, and two risk factors of low PMI and lymph node metastasis were as follows: zero variables, median not reached; one variable, 15.3 months; two variables: 6 months.
Low preoperative PMI may be a risk factor for distal cholangiocarcinoma recurrence after PD.
The Institutional Review Board of St. Marianna University School of Medicine approved this study prior to commencement of data collection and analysis on October 9, 2020 (IRB no. 5006) and waived the informed consent requirement.
本研究旨在探讨术前肌肉量是否与胰十二指肠切除术（PD）后远端胆管癌的复发相关。
我们回顾性分析了 88 例行 PD 治疗的远端胆管癌患者。使用计算机断层扫描测量术前腰大肌质量指数（PMI）作为肌肉量的指标。我们对影响早期复发的因素进行了多变量分析，并使用复发的独立危险因素建立了预后生存模型。
通过受试者工作特征曲线确定的术后 1 年内复发的截断 PMI 值，男性为 5.90cm/m，女性为 3.98cm/m。对 1 年内早期复发的多因素分析表明，低 PMI（比值比[OR]9.322；95%置信区间[CI]2.832-30.678；p=0.0002）和淋巴结转移（OR 5.474；95%CI 1.620-18.497；p=0.0062）是独立的危险因素，低和高 PMI 组的中位无复发生存（RFS）分别为 21.6 和 81.0 个月（p=0.0214）。低 PMI 和淋巴结转移的零、一、两个危险因素的中位 RFS 如下：零变量，中位未达到；一变量，15.3 个月；两变量：6 个月。
术前低 PMI 可能是 PD 后远端胆管癌复发的危险因素。
圣玛丽安娜大学医学院机构审查委员会于 2020 年 10 月 9 日批准了这项研究（IRB 编号 5006），在开始收集和分析数据之前，并豁免了知情同意要求。
