Impact of sarcopenia on postoperative outcomes after hepatectomy in older patients with intrahepatic cholangiocarcinoma: A multicentre cohort study
Background and Aims Sarcopenia is associated with poor prognosis, but its role in older patients with intrahepatic cholangiocarcinoma (ICC) is unclear. We aimed to evaluate the impact of sarcopenia on the prognosis of older patients with ICC undergoing hepatectomy. Methods A total of 363 patients wi...
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| Veröffentlicht in: | Liver international 2024-01, Vol.44 (1), p.155-168 |
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| creator | Zhao, Zhengxiao Bo, Zhiyuan Ye, Ni Dong, Yulong Xu, Yingfei Wang, Binbin Yang, Facai Liu, Liwei Liu, Zhendong |
| description | Background and Aims
Sarcopenia is associated with poor prognosis, but its role in older patients with intrahepatic cholangiocarcinoma (ICC) is unclear. We aimed to evaluate the impact of sarcopenia on the prognosis of older patients with ICC undergoing hepatectomy.
Methods
A total of 363 patients with ICC following hepatectomy from 2015 to 2021 were retrospectively reviewed at five institutions. Sarcopenia was evaluated using skeletal muscle index by computed tomography images. Patients were divided into four subgroups according to sarcopenia and age. Postoperative outcomes including complication, overall survival (OS) and recurrence‐free survival (RFS) were evaluated. Risk factors were identified through univariate and multivariate Cox regression analyses.
Results
302 patients were included in the analysis. The median age was 63 years and there were 128 patients (42.4%) aged over 65 years. 192 patients (63.6%) were diagnosed with sarcopenia, while 180 patients (59.6%) experienced myosteatosis. Older patients experienced a higher incidence of sarcopenia and myosteatosis, and worse postoperative outcomes than younger patients. In the subgroup of patients with sarcopenia, older patients experienced a significant shorter OS than younger patients, which was not observed in patients without sarcopenia. According to the multivariate Cox regression analysis, lymphatic metastasis (p |
| doi_str_mv | 10.1111/liv.15757 |
| format | Article |
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Sarcopenia is associated with poor prognosis, but its role in older patients with intrahepatic cholangiocarcinoma (ICC) is unclear. We aimed to evaluate the impact of sarcopenia on the prognosis of older patients with ICC undergoing hepatectomy.
Methods
A total of 363 patients with ICC following hepatectomy from 2015 to 2021 were retrospectively reviewed at five institutions. Sarcopenia was evaluated using skeletal muscle index by computed tomography images. Patients were divided into four subgroups according to sarcopenia and age. Postoperative outcomes including complication, overall survival (OS) and recurrence‐free survival (RFS) were evaluated. Risk factors were identified through univariate and multivariate Cox regression analyses.
Results
302 patients were included in the analysis. The median age was 63 years and there were 128 patients (42.4%) aged over 65 years. 192 patients (63.6%) were diagnosed with sarcopenia, while 180 patients (59.6%) experienced myosteatosis. Older patients experienced a higher incidence of sarcopenia and myosteatosis, and worse postoperative outcomes than younger patients. In the subgroup of patients with sarcopenia, older patients experienced a significant shorter OS than younger patients, which was not observed in patients without sarcopenia. According to the multivariate Cox regression analysis, lymphatic metastasis (p < .001), blood transfusion (p = .004), low serum albumin (p = .051), sarcopenia (p = .024), and myosteatosis (p = .004) were identified as independent risk factors of OS in older patients, meanwhile tumour size (p = .013) and lymphatic metastasis (p < .001) were independent risk factors of RFS.
Conclusions
Sarcopenia and myosteatosis have a significant adverse impact on postoperative outcomes in older patients with ICC undergoing hepatectomy.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.15757</identifier><identifier>PMID: 37804070</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Bile Duct Neoplasms - pathology ; Bile Ducts, Intrahepatic - pathology ; Blood transfusion ; Cholangiocarcinoma ; Cholangiocarcinoma - pathology ; Computed tomography ; Hepatectomy ; Hepatectomy - adverse effects ; Humans ; intrahepatic cholangiocarcinoma ; Lymphatic Metastasis - pathology ; Medical prognosis ; Metastases ; Metastasis ; Middle Aged ; Multivariate analysis ; myosteatosis ; older people ; Postoperative period ; Prognosis ; Regression analysis ; Retrospective Studies ; Risk factors ; Sarcopenia ; Sarcopenia - complications ; Sarcopenia - diagnostic imaging ; Serum albumin ; Skeletal muscle ; Subgroups ; Survival</subject><ispartof>Liver international, 2024-01, Vol.44 (1), p.155-168</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2023 The Authors. Liver International published by John Wiley & Sons Ltd.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-c849ab03cd8f2cb48121bce03da0680eb3f2e22ed75800a835d0191bf99c3f623</citedby><cites>FETCH-LOGICAL-c3887-c849ab03cd8f2cb48121bce03da0680eb3f2e22ed75800a835d0191bf99c3f623</cites><orcidid>0000-0002-4006-4039 ; 0000-0003-3330-998X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.15757$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.15757$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37804070$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhao, Zhengxiao</creatorcontrib><creatorcontrib>Bo, Zhiyuan</creatorcontrib><creatorcontrib>Ye, Ni</creatorcontrib><creatorcontrib>Dong, Yulong</creatorcontrib><creatorcontrib>Xu, Yingfei</creatorcontrib><creatorcontrib>Wang, Binbin</creatorcontrib><creatorcontrib>Yang, Facai</creatorcontrib><creatorcontrib>Liu, Liwei</creatorcontrib><creatorcontrib>Liu, Zhendong</creatorcontrib><title>Impact of sarcopenia on postoperative outcomes after hepatectomy in older patients with intrahepatic cholangiocarcinoma: A multicentre cohort study</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background and Aims
Sarcopenia is associated with poor prognosis, but its role in older patients with intrahepatic cholangiocarcinoma (ICC) is unclear. We aimed to evaluate the impact of sarcopenia on the prognosis of older patients with ICC undergoing hepatectomy.
Methods
A total of 363 patients with ICC following hepatectomy from 2015 to 2021 were retrospectively reviewed at five institutions. Sarcopenia was evaluated using skeletal muscle index by computed tomography images. Patients were divided into four subgroups according to sarcopenia and age. Postoperative outcomes including complication, overall survival (OS) and recurrence‐free survival (RFS) were evaluated. Risk factors were identified through univariate and multivariate Cox regression analyses.
Results
302 patients were included in the analysis. The median age was 63 years and there were 128 patients (42.4%) aged over 65 years. 192 patients (63.6%) were diagnosed with sarcopenia, while 180 patients (59.6%) experienced myosteatosis. Older patients experienced a higher incidence of sarcopenia and myosteatosis, and worse postoperative outcomes than younger patients. In the subgroup of patients with sarcopenia, older patients experienced a significant shorter OS than younger patients, which was not observed in patients without sarcopenia. According to the multivariate Cox regression analysis, lymphatic metastasis (p < .001), blood transfusion (p = .004), low serum albumin (p = .051), sarcopenia (p = .024), and myosteatosis (p = .004) were identified as independent risk factors of OS in older patients, meanwhile tumour size (p = .013) and lymphatic metastasis (p < .001) were independent risk factors of RFS.
Conclusions
Sarcopenia and myosteatosis have a significant adverse impact on postoperative outcomes in older patients with ICC undergoing hepatectomy.</description><subject>Aged</subject><subject>Bile Duct Neoplasms - pathology</subject><subject>Bile Ducts, Intrahepatic - pathology</subject><subject>Blood transfusion</subject><subject>Cholangiocarcinoma</subject><subject>Cholangiocarcinoma - pathology</subject><subject>Computed tomography</subject><subject>Hepatectomy</subject><subject>Hepatectomy - adverse effects</subject><subject>Humans</subject><subject>intrahepatic cholangiocarcinoma</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>myosteatosis</subject><subject>older people</subject><subject>Postoperative period</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Sarcopenia</subject><subject>Sarcopenia - complications</subject><subject>Sarcopenia - diagnostic imaging</subject><subject>Serum albumin</subject><subject>Skeletal muscle</subject><subject>Subgroups</subject><subject>Survival</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kctKxDAUhoMo3he-gATc6GI0l3aauhPxMjDgRt2GND11Im1PTVJlnsMXNjrqQjCbJP_58udwfkIOODvlaZ217vWU50VerJFtnhVqIoXk679nIbfITgjPjPGyzPkm2ZKFYhkr2DZ5n3WDsZFiQ4PxFgfonaHY0wFDTDdvonsFimO02EGgpong6QIGE8FG7JbU9RTbOolJctDHQN9cXCQ5evPFOUvtAlvTPzm06Q_XY2fO6QXtxjYV0xMP1OICfaQhjvVyj2w0pg2w_73vkofrq_vL28n87mZ2eTGfWKlUMbEqK03FpK1VI2yVKS54ZYHJ2rCpYlDJRoAQUBe5YswomddpALxqytLKZirkLjle-Q4eX0YIUXcuWGhTq4Bj0EIVmZiKTPKEHv1Bn3H0fepOi5JJUWZyKhN1sqKsxxA8NHrwrjN-qTnTn0nplJT-Siqxh9-OY9VB_Uv-RJOAsxXw5lpY_u-k57PHleUHT8ygpA</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Zhao, Zhengxiao</creator><creator>Bo, Zhiyuan</creator><creator>Ye, Ni</creator><creator>Dong, Yulong</creator><creator>Xu, Yingfei</creator><creator>Wang, Binbin</creator><creator>Yang, Facai</creator><creator>Liu, Liwei</creator><creator>Liu, Zhendong</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><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>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4006-4039</orcidid><orcidid>https://orcid.org/0000-0003-3330-998X</orcidid></search><sort><creationdate>202401</creationdate><title>Impact of sarcopenia on postoperative outcomes after hepatectomy in older patients with intrahepatic cholangiocarcinoma: A multicentre cohort study</title><author>Zhao, Zhengxiao ; Bo, Zhiyuan ; Ye, Ni ; Dong, Yulong ; Xu, Yingfei ; Wang, Binbin ; Yang, Facai ; Liu, Liwei ; Liu, Zhendong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3887-c849ab03cd8f2cb48121bce03da0680eb3f2e22ed75800a835d0191bf99c3f623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Bile Duct Neoplasms - pathology</topic><topic>Bile Ducts, Intrahepatic - pathology</topic><topic>Blood transfusion</topic><topic>Cholangiocarcinoma</topic><topic>Cholangiocarcinoma - pathology</topic><topic>Computed tomography</topic><topic>Hepatectomy</topic><topic>Hepatectomy - adverse effects</topic><topic>Humans</topic><topic>intrahepatic cholangiocarcinoma</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>myosteatosis</topic><topic>older people</topic><topic>Postoperative period</topic><topic>Prognosis</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Sarcopenia</topic><topic>Sarcopenia - complications</topic><topic>Sarcopenia - diagnostic imaging</topic><topic>Serum albumin</topic><topic>Skeletal muscle</topic><topic>Subgroups</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Zhengxiao</creatorcontrib><creatorcontrib>Bo, Zhiyuan</creatorcontrib><creatorcontrib>Ye, Ni</creatorcontrib><creatorcontrib>Dong, Yulong</creatorcontrib><creatorcontrib>Xu, Yingfei</creatorcontrib><creatorcontrib>Wang, Binbin</creatorcontrib><creatorcontrib>Yang, Facai</creatorcontrib><creatorcontrib>Liu, Liwei</creatorcontrib><creatorcontrib>Liu, Zhendong</creatorcontrib><collection>Wiley Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhao, Zhengxiao</au><au>Bo, Zhiyuan</au><au>Ye, Ni</au><au>Dong, Yulong</au><au>Xu, Yingfei</au><au>Wang, Binbin</au><au>Yang, Facai</au><au>Liu, Liwei</au><au>Liu, Zhendong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of sarcopenia on postoperative outcomes after hepatectomy in older patients with intrahepatic cholangiocarcinoma: A multicentre cohort study</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2024-01</date><risdate>2024</risdate><volume>44</volume><issue>1</issue><spage>155</spage><epage>168</epage><pages>155-168</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background and Aims
Sarcopenia is associated with poor prognosis, but its role in older patients with intrahepatic cholangiocarcinoma (ICC) is unclear. We aimed to evaluate the impact of sarcopenia on the prognosis of older patients with ICC undergoing hepatectomy.
Methods
A total of 363 patients with ICC following hepatectomy from 2015 to 2021 were retrospectively reviewed at five institutions. Sarcopenia was evaluated using skeletal muscle index by computed tomography images. Patients were divided into four subgroups according to sarcopenia and age. Postoperative outcomes including complication, overall survival (OS) and recurrence‐free survival (RFS) were evaluated. Risk factors were identified through univariate and multivariate Cox regression analyses.
Results
302 patients were included in the analysis. The median age was 63 years and there were 128 patients (42.4%) aged over 65 years. 192 patients (63.6%) were diagnosed with sarcopenia, while 180 patients (59.6%) experienced myosteatosis. Older patients experienced a higher incidence of sarcopenia and myosteatosis, and worse postoperative outcomes than younger patients. In the subgroup of patients with sarcopenia, older patients experienced a significant shorter OS than younger patients, which was not observed in patients without sarcopenia. According to the multivariate Cox regression analysis, lymphatic metastasis (p < .001), blood transfusion (p = .004), low serum albumin (p = .051), sarcopenia (p = .024), and myosteatosis (p = .004) were identified as independent risk factors of OS in older patients, meanwhile tumour size (p = .013) and lymphatic metastasis (p < .001) were independent risk factors of RFS.
Conclusions
Sarcopenia and myosteatosis have a significant adverse impact on postoperative outcomes in older patients with ICC undergoing hepatectomy.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37804070</pmid><doi>10.1111/liv.15757</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4006-4039</orcidid><orcidid>https://orcid.org/0000-0003-3330-998X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Aged Bile Duct Neoplasms - pathology Bile Ducts, Intrahepatic - pathology Blood transfusion Cholangiocarcinoma Cholangiocarcinoma - pathology Computed tomography Hepatectomy Hepatectomy - adverse effects Humans intrahepatic cholangiocarcinoma Lymphatic Metastasis - pathology Medical prognosis Metastases Metastasis Middle Aged Multivariate analysis myosteatosis older people Postoperative period Prognosis Regression analysis Retrospective Studies Risk factors Sarcopenia Sarcopenia - complications Sarcopenia - diagnostic imaging Serum albumin Skeletal muscle Subgroups Survival |
| title | Impact of sarcopenia on postoperative outcomes after hepatectomy in older patients with intrahepatic cholangiocarcinoma: A multicentre cohort study |
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