Sarcopenia as a Prognostic Factor in Patients with Hepatoblastoma: Does It Influence Surgical Outcomes and Survival? Preliminary Retrospective Study.

Autor: Muñoz-Serrano AJ; Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain. Electronic address: ajms1992@gmail.com., Estefanía-Fernández K; Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain., Oterino C; Department of Pediatric Radiology, Hospital Universitario La Paz, Madrid, Spain., Ramírez-Amoros C; Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain., Navarro G; School of Medicine, Universidad Autónoma de Madrid, Spain., Sastre A; Department of Pediatric Hematology and Oncology, Hospital Universitario La Paz, Madrid, Spain., Pérez-Martínez A; Department of Pediatric Hematology and Oncology, Hospital Universitario La Paz, Madrid, Spain., Barrena S; Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain., Oliveros FH; Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain., Martínez L; Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2023 Nov; Vol. 58 (11), pp. 2149-2155. Date of Electronic Publication: 2023 May 16.
DOI: 10.1016/j.jpedsurg.2023.05.007
Abstrakt: Aim: Sarcopenia is associated with poor prognosis in adult oncologic patients, with little evidence of this association in pediatric population, including hepatoblastoma.
Methods: Retrospective study in patients with hepatoblastoma, divided into those with or without sarcopenia. Sarcopenia was assessed by measuring psoas muscle area (PMA) at L4-L5 level on the CT/MR and defined as z-score values ≤ 2. Relapse and mortality were analyzed.
Results: Twenty-one patients (57.1% male) were included, with median age 35.7 months (IQR: 23.5-58.5). Seven (33.3%) had sarcopenia on initial studies compared to 14 (66.7%) who did not. No differences were found between groups in age, weight, PRETEXT, surgical treatment or. α-fetoprotein levels. Sarcopenia was associated with a higher rate of metastases at diagnosis (49.2% vs 0.0%; p = 0.026) and surgical complications (57.1% vs 21.4%, p = 0.047). After a median follow-up of 65.1 months (1.7-144.8), 2 patients (28.6%) had tumor relapse in sarcopenic group compared to 1 (7.1%) in non-sarcopenic group. Two patients died in sarcopenic group and 1 in non-sarcopenic group. Median event-free survival (EFS) was lower in sarcopenic group (100.38 ± 25.63 vs 118.91 ± 11.52 months) as well as overall survival (OS) (101.72 ± 24.86 vs 121.78 ± 8.75 months) with no statistical significance. Five-year EFS was also lower in sarcopenic group (71% vs 93%) as well as 5-year OS (71% vs 87%).
Conclusions: Sarcopenia at diagnosis was associated with a higher rate of metastases and surgical complications in hepatoblastoma. Our data shows the first evidence of its role as a possible poor prognostic factor, influencing survival and risk of relapse.
Level of Evidence: II.
Type of Study: Original article. Retrospective study.
Competing Interests: Conflicts of interest There is nothing to disclose.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: