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Observational Study
. 2018 Sep;97(39):e12076.
doi: 10.1097/MD.0000000000012076.

Impact of sarcopenia on outcomes of patients undergoing pancreatectomy: A retrospective analysis of 107 patients

Mehdi El Amrani  1 , Mathilde Vermersch  2 , Maxence Fulbert  1 , Mathieu Prodeau  1 , Katia Lecolle  1 , Mohamed Hebbar  3 , Olivier Ernst  2 , François-René Pruvot  1 , Stéphanie Truant  1
Affiliations
Observational Study

Impact of sarcopenia on outcomes of patients undergoing pancreatectomy: A retrospective analysis of 107 patients

Mehdi El Amrani et al. Medicine (Baltimore). 2018 Sep.

Abstract

To evaluate the prevalence of sarcopenia in patients undergoing pancreatic surgery and to examine its impact on the surgical outcomes and survival of patients.Skeletal muscle index (SMI) was measured on preoperative CT. A patient was considered sarcopenic if SMI was <38.5 cm/m for a female or <52.4 cm/m for a male. Postoperative pancreatic fistula (POPF) and severe morbidity (Clavien≥3) were analyzed. Survival of patients with cancer was calculated using the Kaplan-Meier method.In total, 107 consecutive patients were included. Among them, 50 (47%) patients were sarcopenic and 65 (60%) were undernourished. The rates of severe morbidity and mortality were comparable between sarcopenic and nonsarcopenic groups. However, all POPF grade B or C and deaths occurred in the sarcopenic or nonsarcopenic overweight group (BMI > 25) with significantly lengthened hospital stays (P = .003). After pancreatectomy for cancer, 31 (40.2%) patients showed postoperative recurrence and 23 (29.9%) died after a median follow-up of 15 ± 13.5 months. Despite comparable histological types and stages, the median overall and disease-free survivals were lower in sarcopenic patients (16 months vs not reached, P = .02 and 11.1 months vs 22.5 months; P = .04, respectively). The multivariate analysis revealed that, sarcopenia trended to increase the risk of death (HR = 2.04, P = .07).Sarcopenia negatively impacted short- and long-term outcomes in patients undergoing pancreatectomy.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Skeletal muscle index was measured at the level of L3 by measuring a total muscle area. Measurements were performed semi-automatically with manual outlining of abdominal muscles.
Figure 2
Figure 2
Distribution of skeletal muscle index according to age (A) and gender (B).
Figure 3
Figure 3
Overall and disease free survival according to sarcopenic status in patients with malignant diseases.
Figure 4
Figure 4
Overall and disease free survival of sarcopenic and nonsarcopenic patients stratified by BMI.
See this image and copyright information in PMC

References

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