Haiducu Carmen, Buzea Catalin Adrian, Delcea Caterina, Brasoveanu Vladislav, Grasu Cristian Mugur, Dan Gheorghe-Andrei
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Cardiology Department, Colentina Clinical Hospital, Bucharest, Romania.
Med Pharm Rep. 2023 Jul;96(3):274-282. doi: 10.15386/mpr-2539. Epub 2023 Jul 27.
In cancer patients sarcopenia may be a predictor for postoperative complications of curative or palliative surgery. Several indices including the total psoas area index (TPAI) are proposed for the diagnosis of this condition, but there is no validated cut-off point.Our study aimed to assess the role of TPAI as a marker for sarcopenia and to compare the utility of previously proposed cut-off values for predicting post-operative complications in patients with digestive cancers undergoing surgery.
We retrospectively included all adult patients with digestive cancers admitted to a tertiary center for elective surgery between January and December 2019. Sarcopenia was considered based on TPAI evaluated on abdominal computed tomography (CT) and for analysis we used different cut-off points published by various authors. The primary endpoint was the occurrence of any complications as defined by the Clavien-Dindo classification. The secondary endpoints were fistula development, low- versus high-grade Clavien-Dindo post-operative complications, moderate or severe anemia at discharge, major bleeding, hypoalbuminemia at discharge, and decrease in albumin levels by at least 1g/dL.
We included 155 patients with a mean age of 64.78 ± 11.40 years, of which 59.35% were males; 58.06% developed postoperative complications. TPAI evaluated as a continuous variable was not a predictor for the development of post-operative complications neither in the general study sample, nor in the gender subgroups of patients. Sarcopenia defined by previously proposed cut-off values was not a predictor of the secondary end-points either.
TPAI as a sole parameter for defining sarcopenia was not a predictor for postoperative complications in patients undergoing surgery for digestive neoplasia.
在癌症患者中，肌肉减少症可能是根治性或姑息性手术后并发症的一个预测指标。已提出包括总腰大肌面积指数（TPAI）在内的多个指标用于诊断这种情况，但尚无经过验证的临界值。我们的研究旨在评估TPAI作为肌肉减少症标志物的作用，并比较先前提出的临界值在预测接受手术的消化道癌症患者术后并发症方面的效用。
我们回顾性纳入了2019年1月至12月在一家三级中心因择期手术入院的所有成年消化道癌症患者。根据腹部计算机断层扫描（CT）评估的TPAI来判定肌肉减少症，分析时我们使用了不同作者发表的不同临界值。主要终点是根据Clavien-Dindo分类定义的任何并发症的发生情况。次要终点包括瘘管形成、Clavien-Dindo分级高低不同的术后并发症、出院时中度或重度贫血、大出血、出院时低蛋白血症以及白蛋白水平至少降低1g/dL。
我们纳入了155例患者，平均年龄为64.78±11.40岁，其中59.35%为男性；58.06%发生了术后并发症。无论是在总体研究样本中，还是在患者性别亚组中，将TPAI作为连续变量评估时，它都不是术后并发症发生的预测指标。根据先前提出的临界值定义的肌肉减少症也不是次要终点的预测指标。
对于接受消化道肿瘤手术的患者，TPAI作为定义肌肉减少症的唯一参数，不是术后并发症的预测指标。
