Kenta Sui1, Takehiro Okabayshi2, Jun Iwata3, Sojiro Morita4, Tatsuaki Sumiyoshi1, Tatsuo Iiyama5, Yasuhiro Shimada6. 1. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi, 781-8555, Japan. 2. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi-City, Kochi, 781-8555, Japan. tokabaya@gmail.com. 3. Department of Diagnostic Pathology, Kochi Health Sciences Center, Kochi-City, Japan. 4. Department of Radiology, Kochi Health Sciences Center, Kochi-City, Japan. 5. Department of Biostatistics, Kochi Medical School, Kochi, Japan. 6. Department of Clinical Oncology, Kochi Health Sciences Center, Kochi-City, Japan.
Abstract
PURPOSES: Sarcopenia is known to be associated with a worse prognosis following abdominal operations; however, the relationship between sarcopenia and the outcomes of pancreaticoduodenectomy remains unclear. MATERIALS: We measured body composition parameters, including total abdominal muscle area, using preoperative staging computed tomography (CT), in patients undergoing pancreaticoduodenectomy for periampullary cancer. The incidence of sarcopenia among these patients was evaluated and multivariable analysis was performed to identify independent predictors of postoperative pancreatic fistula. RESULTS: We identified 335 consecutive patients who were eligible for the study. Patients with sarcopenia had significantly poorer 5-year survival rates than those without sarcopenia (32.4 vs. 51.6%, respectively, P = 0.009). Interestingly, the incidence of Grade B/C pancreatic fistula was significantly lower in the sarcopenia group than in the non-sarcopenia group. Multivariate analysis identified high body mass index and soft pancreatic texture as independent predictors of postoperative pancreatic fistula. CONCLUSION: Sarcopenia may have an independent prognostic effect on the survival of patients with periampullary cancer. Preoperative nutritional intervention and rehabilitation may improve the postoperative outcomes of pancreaticoduodenectomy for periampullary cancer.
PURPOSES: Sarcopenia is known to be associated with a worse prognosis following abdominal operations; however, the relationship between sarcopenia and the outcomes of pancreaticoduodenectomy remains unclear. MATERIALS: We measured body composition parameters, including total abdominal muscle area, using preoperative staging computed tomography (CT), in patients undergoing pancreaticoduodenectomy for periampullary cancer. The incidence of sarcopenia among these patients was evaluated and multivariable analysis was performed to identify independent predictors of postoperative pancreatic fistula. RESULTS: We identified 335 consecutive patients who were eligible for the study. Patients with sarcopenia had significantly poorer 5-year survival rates than those without sarcopenia (32.4 vs. 51.6%, respectively, P = 0.009). Interestingly, the incidence of Grade B/C pancreatic fistula was significantly lower in the sarcopenia group than in the non-sarcopenia group. Multivariate analysis identified high body mass index and soft pancreatic texture as independent predictors of postoperative pancreatic fistula. CONCLUSION:Sarcopenia may have an independent prognostic effect on the survival of patients with periampullary cancer. Preoperative nutritional intervention and rehabilitation may improve the postoperative outcomes of pancreaticoduodenectomy for periampullary cancer.
Entities:
Keywords:
Outcomes; Pancreaticoduodenectomy; Periampullary adenocarcinoma; Sarcopenia; Surgery
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