基于术前CT的喉全切除术后骨骼肌质量消耗与预后
Preoperative CT-Based Skeletal Muscle Mass Depletion and Outcomes after Total Laryngectomy.
作者信息
Salati Victoria, Mandralis Katerina, Becce Fabio, Koerfer Joachim, Lambercy Karma, Simon Christian, Gorostidi François
机构信息
Department of Otolaryngology, Head and Neck Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, Switzerland.
Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, Switzerland.
出版信息
Cancers (Basel). 2023 Jul 8;15(14):3538. doi: 10.3390/cancers15143538.
PURPOSE
To assess the role of preoperative CT-based skeletal muscle mass depletion on postoperative clinical outcomes and survival in patients who underwent total laryngectomy for cancer.
METHODS
Patients operated on between January 2011 and March 2020 were retrospectively included. Skeletal muscle area and intra- and inter-muscular fat accumulation were measured at the third lumbar vertebral level on preoperative CT scans. Skeletal muscle mass depletion was defined based on pre-established cut-off values. Their association with postoperative morbidity, length of stay (LOS), costs, and survival was assessed.
RESULTS
A total of 84 patients were included, of which 37 (44%) had preoperative skeletal muscle mass depletion. The rate of postoperative fistula (23% vs. 35%, = 0.348), cutaneous cervical dehiscence (17% vs. 11%, = 0.629), superficial incisional surgical site infections (SSI) (12% vs. 10%, = 1.000), and unplanned reoperation (38% vs. 37%, = 1.000) were comparable between the two patient groups. No difference in median LOS was observed (41 vs. 33 days, = 0.295), nor in treatment costs (119,976 vs. 109,402 CHF, = 0.585). The median overall survival was comparable between the two groups (3.43 vs. 4.95 years, = 0.09).
CONCLUSIONS
Skeletal muscle mass depletion alone had no significant impact on postoperative clinical outcomes or survival.
目的
评估术前基于CT的骨骼肌质量减少对接受喉癌全喉切除术患者术后临床结局和生存的影响。
方法
回顾性纳入2011年1月至2020年3月接受手术的患者。在术前CT扫描上测量第三腰椎水平的骨骼肌面积以及肌内和肌间脂肪堆积情况。根据预先设定的临界值定义骨骼肌质量减少。评估其与术后发病率、住院时间（LOS）、费用和生存的相关性。
结果
共纳入84例患者，其中37例（44%）术前存在骨骼肌质量减少。两组患者术后瘘管发生率（23%对35%，P = 0.348）、颈部皮肤裂开发生率（17%对11%，P = 0.629）、浅表切口手术部位感染（SSI）发生率（12%对10%，P = 1.000）和计划外再次手术发生率（38%对37%，P = 1.000）相当。两组患者的中位住院时间无差异（41天对33天，P = 0.295），治疗费用也无差异（119,976瑞士法郎对109,402瑞士法郎，P = 0.585）。两组患者的中位总生存期相当（3.43年对4.95年，P = 0.09）。
结论
单纯骨骼肌质量减少对术后临床结局或生存无显著影响。
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