HepatobiliaryImpact of the preoperative quantity and quality of skeletal muscle on outcomes after resection of extrahepatic biliary malignancies
Section snippets
Patients and data collection
A total of 219 consecutive patients underwent resection for extrahepatic biliary cancer with curative intent between January 2004 and December 2013 at Kyoto University. The patients with stage 0 (n = 6) and those who underwent only cholecystectomy (n = 6) were excluded; 207 patients were included in this study. There were 111 men (53.6%) and 96 women (46.4%), and their median age was 68 years (range, 33–85). The locations of the tumor were perihilar bile duct cancer, distal extrahepatic bile
Correlations of PMI and IMAC with patient sex
PMI was greater in males (median, 6.89 cm2/m2; range, 3.39–11.66) than in females (median, 4.49 cm2/m2; range, 2.30–8.07 P < .001), whereas the IMAC was less in males (median, −0.358; range, −0.615 to 0.210) than in females (median, −0.130; range, −0.551 to 0.301; P < .001).
Preoperative characteristics of patients classified by PMI
Preoperative clinicopathologic characteristics of patients with low and normal PMI are shown in Table I. Patients with low PMI were significantly older than those with normal PMI (P = .002). BMI was less in patients with low
Discussion
The results of this retrospective study showed that preoperative PMI and IMAC are independent risk factors for mortality after resection of extrahepatic biliary cancer. To the best of our knowledge, this is the first study to investigate the impact of skeletal muscle mass and quality on survival after resection of extrahepatic biliary cancer.
In the present study, 2 parameters reflecting the quantity (PMI) and quality (IMAC) of skeletal muscle were investigated. Previously, skeletal muscle mass
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2023, American Journal of SurgeryCitation Excerpt :Myopenia is classically characterized by decreased skeletal muscle mass regardless of illness and age,5 and previous studies have demonstrated the unfavorable impacts of oncological outcomes in various malignancies, including esophageal cancer.6–12 Along with the accumulating evidences about the clinical burden of muscle quantity in malignances, emerging studies have gradually revealed the clinical significance of muscle quality in malignancies.13–18 On the other hand, myosteatosis, is known as an accumulation of intramuscular adipose tissue, which is another concept describing meager quality of skeletal muscle that can act as a feasible indicator of sarcopenia in host.19,20
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2022, NutritionCitation Excerpt :In multivariate analysis, sarcopenia was the strongest risk factor for poor RFS and OS. Previous reports have shown that low skeletal muscle mass is an independent risk factor for poor OS in lung, extrahepatic biliary, breast, ovarian, bladder, and pancreatic carcinomas [12–16,19]. In gastric carcinoma, sarcopenia defined by EWGSOP2 is an independent risk factor for disease-free survival and OS [28].
No financial support was received from any source for this study.
The authors declare that there are no conflicts of interest in relation to this study.