Hu Jiawei, Yang Jinhuan, Yu Haitao, Bo Zhiyuan, Chen Kaiwen, Wang Daojie, Xie Yitong, Wang Yi, Chen Gang
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China.
Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Chashan High Education Zone, Wenzhou 325035, China.
Cancers (Basel). 2022 Dec 13;14(24):6144. doi: 10.3390/cancers14246144.
Although sarcopenia has been reported as a negative prognostic factor in patients with hepatocellular carcinoma (HCC), the lack of studies with a prospective design utilizing comprehensive sarcopenia assessment with composite endpoints is an important gap in understanding the impact of sarcopenia in patients with HCC. The aim of this study was to investigate the relationship between sarcopenia and postoperative 1-year mortality and health-related quality of life (HRQOL) based on sarcopenia assessment.
The study cohort, who received resection surgery for HCC between May 2020 and August 2021, was assessed for sarcopenia based on grip strength, the chair stand test, skeletal muscle mass, and gait speed. The primary outcome measures were 1-year mortality and HRQOL determined using the QLQ-C30 questionnaire. In addition, we collected hospital costs, postoperative hospital stays, complications, 30-day and 90-day mortality, and 90- and 180-day readmission rates. Univariate and multivariate linear regression analyses were conducted to examine factors associated with global health status.
A total of 153 eligible patients were included in the cohort. One-year mortality was higher in patients with sarcopenia than in those without sarcopenia ( = 0.043). There was a correlation between sarcopenia and the surgical approach to global health status ( = 0.025) and diarrhea ( = 0.003).
Preoperative sarcopenia reduces postoperative survival and health-related quality of life in patients with HCC.
尽管肌肉减少症已被报道为肝细胞癌(HCC)患者的不良预后因素,但缺乏采用综合肌肉减少症评估和复合终点的前瞻性设计研究,这是理解肌肉减少症对HCC患者影响方面的一个重要差距。本研究的目的是基于肌肉减少症评估,探讨肌肉减少症与术后1年死亡率及健康相关生活质量(HRQOL)之间的关系。
对2020年5月至2021年8月期间接受HCC切除手术的研究队列,根据握力、椅子站立试验、骨骼肌质量和步速评估肌肉减少症。主要结局指标为使用QLQ-C30问卷确定的1年死亡率和HRQOL。此外,我们收集了住院费用、术后住院时间、并发症、30天和90天死亡率以及90天和180天再入院率。进行单因素和多因素线性回归分析以检查与总体健康状况相关的因素。
该队列共纳入153例符合条件的患者。肌肉减少症患者的1年死亡率高于无肌肉减少症的患者(P = 0.043)。肌肉减少症与总体健康状况的手术方式(P = 0.025)和腹泻(P = 0.003)之间存在相关性。
术前肌肉减少症会降低HCC患者的术后生存率和健康相关生活质量。