Sarcopenia and frailty as predictors of surgical morbidity and oncologic outcomes in retroperitoneal sarcoma
Background Retroperitoneal sarcomas (RPS) are rare tumors for which surgical resection is the principal treatment. There is no established model to predict perioperative risks for RPS. We evaluated the association between preoperative sarcopenia, frailty, and hypoalbuminemia with surgical and oncolo...
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| Veröffentlicht in: | Journal of surgical oncology 2023-04, Vol.127 (5), p.855-861 |
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| container_title | Journal of surgical oncology |
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| creator | Nasirishargh, Aida Grova, Monica Bateni, Cyrus P. Judge, Sean J. Nuno, Miriam A. Basmaci, Ugur Nur Canter, Robert J. Bateni, Sarah B. |
| description | Background
Retroperitoneal sarcomas (RPS) are rare tumors for which surgical resection is the principal treatment. There is no established model to predict perioperative risks for RPS. We evaluated the association between preoperative sarcopenia, frailty, and hypoalbuminemia with surgical and oncological outcomes.
Methods
We performed a prospective cohort analysis of 65 RPS patients who underwent surgical resection. Sarcopenia was defined as Total Psoas Area Index ≤ 1st quintile by sex. Frailty was estimated using the modified frailty index (mFI). Logistic regression models were used to assess predictors of 30‐day postoperative morbidity. The Kaplan–Meier method with log‐rank test was utilized to assess factors associated with overall (OS) and recurrence‐free survival (RFS).
Result
Sarcopenia was associated with worse OS with a median of 54 compared with 158 months (p = 0.04), but no differences in RFS (p > 0.05). Hypoalbuminemia was associated with worse OS with a median of 72 compared with 158 months (p 0.05). Sarcopenia, mFI, and hypoalbuminemia were not associated with postoperative morbidity (p > 0.05).
Conclusion
This study suggests that sarcopenia may be utilized as a measure of overall fitness, rather than a cancer‐specific risk, and the mFI is a poor predictive measure of outcomes in RPS. |
| doi_str_mv | 10.1002/jso.27199 |
| format | Article |
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Retroperitoneal sarcomas (RPS) are rare tumors for which surgical resection is the principal treatment. There is no established model to predict perioperative risks for RPS. We evaluated the association between preoperative sarcopenia, frailty, and hypoalbuminemia with surgical and oncological outcomes.
Methods
We performed a prospective cohort analysis of 65 RPS patients who underwent surgical resection. Sarcopenia was defined as Total Psoas Area Index ≤ 1st quintile by sex. Frailty was estimated using the modified frailty index (mFI). Logistic regression models were used to assess predictors of 30‐day postoperative morbidity. The Kaplan–Meier method with log‐rank test was utilized to assess factors associated with overall (OS) and recurrence‐free survival (RFS).
Result
Sarcopenia was associated with worse OS with a median of 54 compared with 158 months (p = 0.04), but no differences in RFS (p > 0.05). Hypoalbuminemia was associated with worse OS with a median of 72 compared with 158 months (p < 0.01). MFI scores were not associated with OS or RFS (p > 0.05). Sarcopenia, mFI, and hypoalbuminemia were not associated with postoperative morbidity (p > 0.05).
Conclusion
This study suggests that sarcopenia may be utilized as a measure of overall fitness, rather than a cancer‐specific risk, and the mFI is a poor predictive measure of outcomes in RPS.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.27199</identifier><identifier>PMID: 36621854</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Frailty ; Frailty - complications ; Frailty - epidemiology ; Gastric cancer ; Humans ; hypoalbuminemia ; Hypoalbuminemia - complications ; Hypoalbuminemia - epidemiology ; Morbidity ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Prospective Studies ; recurrence ; Retroperitoneal Neoplasms - complications ; Retroperitoneal Neoplasms - surgery ; retroperitoneal sarcoma ; Retrospective Studies ; Sarcoma ; Sarcoma - complications ; Sarcoma - surgery ; Sarcopenia ; Sarcopenia - complications ; Sarcopenia - epidemiology ; Sarcopenia - pathology ; survival ; total psoas area index</subject><ispartof>Journal of surgical oncology, 2023-04, Vol.127 (5), p.855-861</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-56dfa3e040eafba85133baf2fcab1aad61c6d5b0c625d7183abeacc920d820e43</citedby><cites>FETCH-LOGICAL-c3539-56dfa3e040eafba85133baf2fcab1aad61c6d5b0c625d7183abeacc920d820e43</cites><orcidid>0000-0002-3331-5418</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.27199$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.27199$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36621854$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nasirishargh, Aida</creatorcontrib><creatorcontrib>Grova, Monica</creatorcontrib><creatorcontrib>Bateni, Cyrus P.</creatorcontrib><creatorcontrib>Judge, Sean J.</creatorcontrib><creatorcontrib>Nuno, Miriam A.</creatorcontrib><creatorcontrib>Basmaci, Ugur Nur</creatorcontrib><creatorcontrib>Canter, Robert J.</creatorcontrib><creatorcontrib>Bateni, Sarah B.</creatorcontrib><title>Sarcopenia and frailty as predictors of surgical morbidity and oncologic outcomes in retroperitoneal sarcoma</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Retroperitoneal sarcomas (RPS) are rare tumors for which surgical resection is the principal treatment. There is no established model to predict perioperative risks for RPS. We evaluated the association between preoperative sarcopenia, frailty, and hypoalbuminemia with surgical and oncological outcomes.
Methods
We performed a prospective cohort analysis of 65 RPS patients who underwent surgical resection. Sarcopenia was defined as Total Psoas Area Index ≤ 1st quintile by sex. Frailty was estimated using the modified frailty index (mFI). Logistic regression models were used to assess predictors of 30‐day postoperative morbidity. The Kaplan–Meier method with log‐rank test was utilized to assess factors associated with overall (OS) and recurrence‐free survival (RFS).
Result
Sarcopenia was associated with worse OS with a median of 54 compared with 158 months (p = 0.04), but no differences in RFS (p > 0.05). Hypoalbuminemia was associated with worse OS with a median of 72 compared with 158 months (p < 0.01). MFI scores were not associated with OS or RFS (p > 0.05). Sarcopenia, mFI, and hypoalbuminemia were not associated with postoperative morbidity (p > 0.05).
Conclusion
This study suggests that sarcopenia may be utilized as a measure of overall fitness, rather than a cancer‐specific risk, and the mFI is a poor predictive measure of outcomes in RPS.</description><subject>Frailty</subject><subject>Frailty - complications</subject><subject>Frailty - epidemiology</subject><subject>Gastric cancer</subject><subject>Humans</subject><subject>hypoalbuminemia</subject><subject>Hypoalbuminemia - complications</subject><subject>Hypoalbuminemia - epidemiology</subject><subject>Morbidity</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prospective Studies</subject><subject>recurrence</subject><subject>Retroperitoneal Neoplasms - complications</subject><subject>Retroperitoneal Neoplasms - surgery</subject><subject>retroperitoneal sarcoma</subject><subject>Retrospective Studies</subject><subject>Sarcoma</subject><subject>Sarcoma - complications</subject><subject>Sarcoma - surgery</subject><subject>Sarcopenia</subject><subject>Sarcopenia - complications</subject><subject>Sarcopenia - epidemiology</subject><subject>Sarcopenia - pathology</subject><subject>survival</subject><subject>total psoas area index</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10b1OwzAUBWALgWgpDLwAssQCQ-DaSdx4RBW_QuoAzNGN7SBXSVzsRKhvj0sKAxKTh_v52LqHkFMGVwyAX6-Cu-JzJuUemTKQIpEgi30yjTOeZHMJE3IUwgoApBTZIZmkQnBW5NmUNC_olVubziLFTtPao236DcVA195oq3rnA3U1DYN_twob2jpfWW23JnrXKde4OKFu6JVrTaC2o970PoZ627vOxDth-0iLx-SgxiaYk905I293t6-Lh-R5ef-4uHlOVJqnMsmFrjE1kIHBusIiZ2laYc1rhRVD1IIpofMKlOC5nrMixcqgUpKDLjiYLJ2RizF37d3HYEJftjYo0zTYGTeEks8FL5gAUUR6_oeu3OC7-Luoihxk3BlEdTkq5V0I3tTl2tsW_aZkUG4rKGMF5XcF0Z7tEoeqNfpX_uw8gusRfNrGbP5PKp9elmPkF4Ktks4</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Nasirishargh, Aida</creator><creator>Grova, Monica</creator><creator>Bateni, Cyrus P.</creator><creator>Judge, Sean J.</creator><creator>Nuno, Miriam A.</creator><creator>Basmaci, Ugur Nur</creator><creator>Canter, Robert J.</creator><creator>Bateni, Sarah B.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3331-5418</orcidid></search><sort><creationdate>202304</creationdate><title>Sarcopenia and frailty as predictors of surgical morbidity and oncologic outcomes in retroperitoneal sarcoma</title><author>Nasirishargh, Aida ; Grova, Monica ; Bateni, Cyrus P. ; Judge, Sean J. ; Nuno, Miriam A. ; Basmaci, Ugur Nur ; Canter, Robert J. ; Bateni, Sarah B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-56dfa3e040eafba85133baf2fcab1aad61c6d5b0c625d7183abeacc920d820e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Frailty</topic><topic>Frailty - complications</topic><topic>Frailty - epidemiology</topic><topic>Gastric cancer</topic><topic>Humans</topic><topic>hypoalbuminemia</topic><topic>Hypoalbuminemia - complications</topic><topic>Hypoalbuminemia - epidemiology</topic><topic>Morbidity</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Prospective Studies</topic><topic>recurrence</topic><topic>Retroperitoneal Neoplasms - complications</topic><topic>Retroperitoneal Neoplasms - surgery</topic><topic>retroperitoneal sarcoma</topic><topic>Retrospective Studies</topic><topic>Sarcoma</topic><topic>Sarcoma - complications</topic><topic>Sarcoma - surgery</topic><topic>Sarcopenia</topic><topic>Sarcopenia - complications</topic><topic>Sarcopenia - epidemiology</topic><topic>Sarcopenia - pathology</topic><topic>survival</topic><topic>total psoas area index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nasirishargh, Aida</creatorcontrib><creatorcontrib>Grova, Monica</creatorcontrib><creatorcontrib>Bateni, Cyrus P.</creatorcontrib><creatorcontrib>Judge, Sean J.</creatorcontrib><creatorcontrib>Nuno, Miriam A.</creatorcontrib><creatorcontrib>Basmaci, Ugur Nur</creatorcontrib><creatorcontrib>Canter, Robert J.</creatorcontrib><creatorcontrib>Bateni, Sarah B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nasirishargh, Aida</au><au>Grova, Monica</au><au>Bateni, Cyrus P.</au><au>Judge, Sean J.</au><au>Nuno, Miriam A.</au><au>Basmaci, Ugur Nur</au><au>Canter, Robert J.</au><au>Bateni, Sarah B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sarcopenia and frailty as predictors of surgical morbidity and oncologic outcomes in retroperitoneal sarcoma</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2023-04</date><risdate>2023</risdate><volume>127</volume><issue>5</issue><spage>855</spage><epage>861</epage><pages>855-861</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Retroperitoneal sarcomas (RPS) are rare tumors for which surgical resection is the principal treatment. There is no established model to predict perioperative risks for RPS. We evaluated the association between preoperative sarcopenia, frailty, and hypoalbuminemia with surgical and oncological outcomes.
Methods
We performed a prospective cohort analysis of 65 RPS patients who underwent surgical resection. Sarcopenia was defined as Total Psoas Area Index ≤ 1st quintile by sex. Frailty was estimated using the modified frailty index (mFI). Logistic regression models were used to assess predictors of 30‐day postoperative morbidity. The Kaplan–Meier method with log‐rank test was utilized to assess factors associated with overall (OS) and recurrence‐free survival (RFS).
Result
Sarcopenia was associated with worse OS with a median of 54 compared with 158 months (p = 0.04), but no differences in RFS (p > 0.05). Hypoalbuminemia was associated with worse OS with a median of 72 compared with 158 months (p < 0.01). MFI scores were not associated with OS or RFS (p > 0.05). Sarcopenia, mFI, and hypoalbuminemia were not associated with postoperative morbidity (p > 0.05).
Conclusion
This study suggests that sarcopenia may be utilized as a measure of overall fitness, rather than a cancer‐specific risk, and the mFI is a poor predictive measure of outcomes in RPS.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36621854</pmid><doi>10.1002/jso.27199</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3331-5418</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Frailty Frailty - complications Frailty - epidemiology Gastric cancer Humans hypoalbuminemia Hypoalbuminemia - complications Hypoalbuminemia - epidemiology Morbidity Postoperative Complications - epidemiology Postoperative Complications - etiology Prospective Studies recurrence Retroperitoneal Neoplasms - complications Retroperitoneal Neoplasms - surgery retroperitoneal sarcoma Retrospective Studies Sarcoma Sarcoma - complications Sarcoma - surgery Sarcopenia Sarcopenia - complications Sarcopenia - epidemiology Sarcopenia - pathology survival total psoas area index |
| title | Sarcopenia and frailty as predictors of surgical morbidity and oncologic outcomes in retroperitoneal sarcoma |
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