Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-Shi, Saitama, 350-1298, Japan.
Surg Today. 2024 Jul;54(7):702-711. doi: 10.1007/s00595-023-02788-5. Epub 2024 Jan 16.
PURPOSE: The development of sarcopenia after esophagectomy is reported to affect the outcomes of patients with esophageal cancer (EC); however, the characteristics of patients likely to be predisposed to postoperative sarcopenia have not been defined. This study explores the associations between preoperative respiratory function and surgery-induced sarcopenia in EC patients confirmed as nonsarcopenic preoperatively. METHODS: The subjects of this retrospective review were 128 nonsarcopenic patients who underwent esophagectomy for EC. We took body composition measurements and performed physical function tests 3 and 6 months postoperatively, to establish whether sarcopenia was present, according to the 2019 Asian Working Group for Sarcopenia guideline. We defined patients with surgery-induced sarcopenia as those with evidence of the development of sarcopenia within 6 months postoperatively or those with documented sarcopenia at 3 months but who could not be evaluated at 6 months. RESULTS: Surgery-induced sarcopenia developed in 19 of the 128 patients (14.8%), which correlated significantly with the preoperative %VC value (p < 0.01), but not with the preoperative FEV1.0% value. We set the lower quartile %VC value (91%) as the cut-off for predicting surgery-induced sarcopenia. A low %VC was independently associated with surgery-induced sarcopenia (odds ratio: 5.74; 95% confidence interval: 1.99-16.57; p < 0.01). CONCLUSIONS: Based on the findings of this study, %VC was a simple but valuable factor for predicting sarcopenia induced by esophagectomy.
目的:据报道,食管癌(EC)患者术后发生恶病质会影响其预后;然而,易发生术后恶病质的患者特征尚未明确。本研究旨在探讨术前呼吸功能与术前非恶病质的 EC 患者术后发生肌少症之间的关系。
方法:本回顾性研究的对象为 128 例因 EC 行食管切除术且术前非恶病质的患者。我们在术后 3 个月和 6 个月时进行身体成分测量和身体功能测试,根据 2019 年亚洲肌少症工作组指南确定是否存在肌少症。我们将术后发生肌少症的患者定义为术后 6 个月内出现肌少症进展的患者,或 3 个月时已存在肌少症但 6 个月时无法评估的患者。
结果:128 例患者中有 19 例(14.8%)发生术后肌少症,与术前 %VC 值显著相关(p<0.01),但与术前 FEV1.0%值无关。我们将较低四分位 %VC 值(91%)作为预测术后肌少症的截止值。低 %VC 与术后肌少症独立相关(优势比:5.74;95%置信区间:1.99-16.57;p<0.01)。
结论:基于本研究结果,%VC 是预测食管切除术后肌少症的一个简单但有价值的因素。
Hepatogastroenterology. 2002
Medicine (Baltimore). 2022-9-2
Transl Cancer Res. 2020-9