Misc.

Oct, 2016

Sarcopenia and American Society of Anesthesiologists Physical Status in the Assessment of Outcomes of Hepatocellular Carcinoma Patients Undergoing Hepatectomy

ACTA MEDICA OKAYAMA
  • Kosei Takagi
  • ,
  • Takahito Yagi
  • ,
  • Ryuichi Yoshida
  • ,
  • Susumu Shinoura
  • ,
  • Yuzo Umeda
  • ,
  • Daisuke Nobuoka
  • ,
  • Takashi Kuise
  • ,
  • Nobuyuki Watanabe
  • ,
  • Toshiyoshi Fujiwara

Volume
70
Number
5
First page
363
Last page
370
Language
English
Publishing type
DOI
10.18926/AMO/54594
Publisher
OKAYAMA UNIV MED SCHOOL

Sarcopenia following liver surgery has been reported as a predictor of poor prognosis. Here we investigated predictors of outcomes in patients with hepatocellular carcinoma (HCC) and attempted to establish a new comprehensive preoperative assessment protocol. We retrospectively analyzed the cases of 254 patients who underwent curative hepatectomy for HCC with Child-Pugh classification A at our hospital between January 2007 and December 2013. Sarcopenia was evaluated by computed tomography measurement. The influence of sarcopenia on outcomes was evaluated. We used multivariate analyses to assess the impact of prognostic factors associated with outcomes, including sarcopenia. Of the 254 patients, 118 (46.5) met the criteria for sarcopenia, and 32 had an American Society of Anesthesiologists (ASA) physical status >= 3. The sarcopenic group had a significantly lower 5-year overall survival rate than the non-sarcopenic group (58.2 vs. 82.4, p=0.0002). In multivariate analyses of prognostic factors, sarcopenia was an independent predictor of poor survival (hazard ratio [HR]= 2.28, p= 0.002) and poor ASA status (HR= 3.17, p= 0.001). Sarcopenia and poor ASA status are independent preoperative predictors for poor outcomes after hepatectomy. The preoperative identification of sarcopenia and ASA status might enable the development of comprehensive approaches to assess surgical eligibility.

Link information
DOI
https://doi.org/10.18926/AMO/54594
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000388098700005&DestApp=WOS_CPL
ID information
  • DOI : 10.18926/AMO/54594
  • ISSN : 0386-300X
  • Web of Science ID : WOS:000388098700005

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