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高内脏脂肪与肝内胆管细胞癌肝切除术后生存状况较差相关。

High Visceral Fat is Associated with a Worse Survival after Liver Resection for Intrahepatic Cholangiocarcinoma.

机构信息

Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Univ Rennes, Rennes, France.

Unité de Nutrition, service Endocrinologie-Diabétologie-Nutrition, CHU Rennes, Rennes, France.

出版信息

Nutr Cancer. 2023;75(1):339-348. doi: 10.1080/01635581.2022.2117387. Epub 2022 Sep 2.

Abstract

The impact of body composition (BC) on the prognosis of resected intrahepatic cholangiocarcinoma (ICC) has been poorly studied. i) to evaluate the prevalence of low muscle mass (MM) in patients; ii) to assess the impact of BC on patient overall survival (OS) and disease-free survival (DFS), and iii) on the incidence of postoperative complications. All consecutive patients who underwent liver resection for ICC between 2004 and 2016 and who had preoperative CT scans were included. Ninety-three patients were included. Sixty percent (55/91) had low total MM. On multivariable analysis, high visceral fat (HR 2.48, CI95% [1.63; 3.77],  < 0.0001), nodules >1 (HR 3.15 [1.67; 5.93],  = 0.0004), involvement adjacent organ (HR 6.67 [1.88; 23.69],  = 0.003), and postoperative sepsis (HR 3.04 [1.54; 5.99],  = 0.0013) were independently associated with OS. High visceral fat (HR 2.10 [1.31; 3.38],  = 0.002], nodules >1 (HR 3.01, [1.49; 6.10],  = 0.002), postoperative sepsis (HR 5.16 [2.24; 11.89],  = 0.0001), ASA score ( = 0.02) and perineural invasion (HR 3.30 [1.62; 6.76],  = 0.001) were independently associated with lower DFS. 60% of ICC patients had low MM before surgery. High visceral fat, but not muscle mass, was an independent prognostic factor for poor OS and DFS in European patients with resected ICC.

摘要

术前低肌肉量在肝内胆管细胞癌(ICC)患者中较为常见。我们旨在:i)评估术前低肌肉量(MM)在患者中的发生率;ii)评估体成分(BC)对患者总生存(OS)和无病生存(DFS)的影响,以及 iii)评估术后并发症的发生率。纳入 2004 年至 2016 年间接受肝切除术治疗 ICC 且术前 CT 扫描的连续患者。共纳入 93 例患者。60%(55/91)的患者总 MM 较低。多变量分析显示,高内脏脂肪(HR 2.48,95%CI[1.63;3.77], < 0.0001)、结节>1(HR 3.15,[1.67;5.93], = 0.0004)、临近器官受累(HR 6.67,[1.88;23.69], = 0.003)和术后脓毒症(HR 3.04,[1.54;5.99], = 0.0013)与 OS 独立相关。高内脏脂肪(HR 2.10,[1.31;3.38], = 0.002)、结节>1(HR 3.01,[1.49;6.10], = 0.002)、术后脓毒症(HR 5.16,[2.24;11.89], = 0.0001)、ASA 评分( = 0.02)和神经周围侵犯(HR 3.30,[1.62;6.76], = 0.001)与较低的 DFS 独立相关。60%的 ICC 患者术前存在低 MM。高内脏脂肪,而不是肌肉量,是欧洲接受 ICC 切除术患者 OS 和 DFS 不良的独立预后因素。

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