Prognostic Significance of Sarcopenia and Systemic Inflammatory Markers in Biliary Tract Cancer: A Retrospective Cohort Study.

Autor: Utsumi M; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan. utsumi.masashi.vn@mail.hosp.go.jp., Inagaki M; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Kitada K; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Tokunaga N; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Yonoki K; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Sakurai Y; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Okabayashi H; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Hamano R; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Miyasou H; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Tsunemitsu Y; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan., Otsuka S; Department of Surgery, NHO Fukuyama Medical Center, 4-14-17 Okinogami-Cho, Fukuyama, Hiroshima, 720-8520, Japan.
Jazyk: angličtina
Zdroj: Journal of gastrointestinal cancer [J Gastrointest Cancer] 2024 Jun; Vol. 55 (2), pp. 888-899. Date of Electronic Publication: 2024 Feb 26.
DOI: 10.1007/s12029-024-01034-6
Abstrakt: Purpose: To evaluate the prognostic significance of sarcopenia and systemic inflammatory markers in patients with surgically resected biliary tract cancer (BTC).
Methods: Between July 2010 and December 2022, 146 patients were recruited. Sarcopenia was assessed using the psoas muscle index. Preoperative inflammatory markers were used to calculate the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. Cox regression analysis was performed to determine prognostic factors for overall survival (OS) and recurrence-free survival (RFS). P < 0.05 was considered statistically significant.
Results: Sixty-four patients had sarcopenia. Sarcopenia was associated with body mass index (< 22 kg/m 2 ), lymph node metastasis, and low PNI (< 42). R1/R2 resection (P = 0.02), sarcopenia (P < 0.001), lymph node metastasis (P = 0.007), intrahepatic cholangiocarcinoma (P < 0.001), and low PNI (P = 0.01) were independent predictors of OS, while male sex (P = 0.04), R1/R2 resection (P < 0.001), lymph node metastasis (P = 0.005), intrahepatic cholangiocarcinoma (P < 0.001), tumor differentiation (other than well; P = 0.003), and low PNI (P = 0.03) were independent predictors of RFS. Patients were stratified into no sarcopenia and high PNI (≥ 42; A), sarcopenia or low PNI (B), and sarcopenia and low PNI (C) groups. Group C had worse OS than the other two groups (P < 0.001 and P = 0.02, respectively).
Conclusion: Sarcopenia is associated with the PNI. Sarcopenia and the PNI are independent prognostic factors among patients with resected BTC. Sarcopenia may have better prognostic value when combined with the PNI.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: