Wang Qiang, Wang Anrong, Li Zhen, Sparrelid Ernesto, Brismar Torkel B
Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Front Oncol. 2022 Nov 24;12:1064785. doi: 10.3389/fonc.2022.1064785. eCollection 2022.
The impact of sarcopenia on the future liver remnant (FLR) growth after portal vein occlusion, including portal vein embolization (PVE) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has gained increasing interest. This systematic review aimed to explore whether sarcopenia was associated with insufficient FLR growth after PVE/ALPPS stage-1.
A systematic literature search was performed in PubMed, Embase, Web of Science, and Cochrane Library up to 05 July 2022. Studies evaluating the influence of sarcopenia on FLR growth after PVE/ALPPS stage-1 in patients with liver cancer were included. A predefined table was used to extract information including the study and patient characteristics, sarcopenia measurement, FLR growth, post-treatment complications and post-hepatectomy liver failure, resection rate. Research quality was evaluated by the Newcastle-Ottawa Scale.
Five studies consisting of 609 patients were included in this study, with a sample size ranging from 42 to 306 (median: 90) patients. Only one study was multicenter research. The incidence of sarcopenia differed from 40% to 67% (median: 63%). Skeletal muscle index based on pretreatment computed tomography was the commonly used parameter for sarcopenia evaluation. All included studies showed that sarcopenia impaired the FLR growth after PVE/ALPPS stage-1. However, the association between sarcopenia and post-treatment complications, post-hepatectomy liver failure, and resection rate remains unclear. All studies showed moderate-to-high quality.
Sarcopenia seems to be prevalent in patients undergoing PVE/ALPPS and may be a risk factor for impaired liver growth after PVE/ALPPS stage-1 according to currently limited evidence.
https://inplasy.com/, identifier INPLASY202280038.
肌肉减少症对门静脉闭塞（包括门静脉栓塞术（PVE）和联合肝脏分隔及门静脉结扎分期肝切除术（ALPPS））后未来肝残余（FLR）生长的影响已越来越受到关注。本系统评价旨在探讨肌肉减少症是否与PVE/ALPPS一期术后FLR生长不足相关。
截至2022年7月5日，在PubMed、Embase、Web of Science和Cochrane图书馆进行了系统的文献检索。纳入评估肌肉减少症对肝癌患者PVE/ALPPS一期术后FLR生长影响的研究。使用预定义表格提取信息，包括研究和患者特征、肌肉减少症测量、FLR生长、治疗后并发症和肝切除术后肝功能衰竭、切除率。研究质量采用纽卡斯尔-渥太华量表进行评估。
本研究纳入了5项研究，共609例患者，样本量从42例至306例（中位数：90例）。只有1项研究为多中心研究。肌肉减少症的发生率在40%至67%之间（中位数：63%）。基于术前计算机断层扫描的骨骼肌指数是评估肌肉减少症常用的参数。所有纳入研究均表明，肌肉减少症会损害PVE/ALPPS一期术后的FLR生长。然而，肌肉减少症与治疗后并发症、肝切除术后肝功能衰竭及切除率之间的关联仍不明确。所有研究质量为中到高。
根据目前有限的证据，肌肉减少症在接受PVE/ALPPS的患者中似乎很普遍，可能是PVE/ALPPS一期术后肝脏生长受损的一个危险因素。
