Abstract
Background
The impact of sarcopenia on textbook outcome (TO) after hepatectomy in hepatocellular
carcinoma (HCC) patients remains unclear. This study aimed to investigate the association
between sarcopenia and TO, to clarify its long and short-term prognostic value, and
to develop a nomogram model based on sarcopenia and TO for survival prediction.
Methods
Patients who underwent HCC resection between January 2012 and March 2017 in three
large hospitals in Fujian were retrospectively recruited and divided into sarcopenia
and non-sarcopenia groups based on skeletal muscle index (SMI) values. TO was defined
as no 30-day morality, no 30-day readmission, negative margins, no prolonged hospital
stay, and no major complications. Multivariate regression was used to screen for clinical
factors associated with TO. Nomograms of overall survival (OS) and recurrence-free
survival (RFS) after hepatectomy for HCC were developed.
Results
A total of 1172 patients were included in the study. The TO rates were 28.74% (121/421
patients) in the sarcopenia group and 43.4% (326/751 patients) in the non-sarcopenia
group. The results showed that sarcopenia was an independent predictor of TO (p < 0.001),
TO was an independent predictor of perioperative treatment-related sarcopenia (PTRS)(p = 0.002),
and TO was an independent predictor of OS and RFS (p < 0.001). Nomogram models based
on sarcopenia and TO were generated and accurately predicted OS and RFS at 1, 3, and
5 years.
Conclusion
Both sarcopenia and TO are independent predictors of OS and RFS after HCC resection.
Sarcopenia was an independent predictor of TO. Sarcopenia influenced long-term survival
by affecting short-term postoperative outcomes.
Keywords
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References
- Bray F.,et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA A Cancer J Clin. 2021; 71: 209-249
- New advances in the diagnosis and management of hepatocellular carcinoma.Br Med J. 2020; 371: m3544
- Choosing a hospital for surgery: the importance of information on quality of care.Med Decis Making. 2010; 30: 544-555
- Composite measures for predicting surgical mortality in the hospital.Health Aff. 2009; 28: 1189-1198
- Quality improvement in gastrointestinal surgical oncology with American college of surgeons national surgical quality improvement Program.Surgery. 2014; 155: 593-601
- Composite measures for rating hospital quality with major surgery.Health Serv Res. 2012; 47: 1861-1879
- Focusing on desired outcomes of care after colon cancer resections; hospital variations in ’textbook outcome.Eur J Surg Oncol. 2013; 39: 156-163
- Textbook outcome: a composite measure for quality of elective aneurysm surgery.Ann Surg. 2017; 266: 898-904
- Textbook outcome and survival of robotic versus laparoscopic total gastrectomy for gastric cancer: a propensity score matched cohort study.Sci Rep. 2021; 1115394
- Textbook oncologic outcome is associated with increased overall survival after esophagectomy.Surgery. 2020; 168: 953-961
- Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers.J Hepatol. 2020; 73: 1100-1108
- Assessing textbook outcomes following liver surgery for primary liver cancer over a 12-year time period at major hepatobiliary centers.Ann Surg Oncol. 2020; 27: 3318-3327
- Hospital variation in Textbook Outcomes following curative-intent resection of hepatocellular carcinoma: an international multi-institutional analysis.HPB. 2020; 22: 1305-1313
Görgec B., Benedetti Cacciaguerra A., Lanari J., Russolillo N., Cipriani F., Aghayan D., et al. Assessment of Textbook Outcome in Laparoscopic and Open Liver Surgery. JAMA Surg 2021 Aug 1;156(8):e212064.
- Epidemiology of hepatocellular carcinoma.Hepatology. 2021; 73 (Suppl 1): 4-13
- A multi-institutional international analysis of textbook outcomes among patients undergoing curative-intent resection of intrahepatic cholangiocarcinoma.JAMA Surg. 2019; 154e190571
- Changing epidemiology of hepatocellular carcinoma in Asia.Best Pract Res Clin Gastroenterol. 2015; 29: 919-928
- Hepatocellular carcinoma (HCC): epidemiology, etiology and molecular classification.Adv Cancer Res. 2021; 149: 1-61
- Epidemiology and management of hepatocellular carcinoma.Gastroenterology. 2019; 156 (e471): 477-491
- Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma: a large multicenter sample analysis.Chin J Cancer Res. 2021; 33: 433-446
- Cancer cachexia and its pathophysiology: links with sarcopenia, anorexia and asthenia.J Cachexia Sarcopenia Muscle. 2020; 11: 619-635
- Prognostic value and association of sarcopenic obesity and systemic inflammatory indexes in patients with hepatocellular carcinoma following hepatectomy and the establishment of novel predictive nomograms.J Gastrointest Oncol. 2021; 12: 669-693
- The association of neighborhood social vulnerability with surgical textbook outcomes among patients undergoing hepatopancreatic surgery.Surgery. 2020; 168: 868-875
- Textbook outcomes among medicare patients undergoing hepatopancreatic surgery.Ann Surg. 2020; 271: 1116-1123
- Organizational determinants of hospital stay: increasing hospital efficiency.Intern Emerg Med. 2020; 15: 925-927
- A higher hospital case mix index increases the odds of achieving a textbook outcome after hepatopancreatic surgery in the Medicare population.Surgery. 2021; 170: 1525-1531
- ASO author reflections: chance of textbook outcome following hepatopancreatic surgery varies based on cancer center designation.Ann Surg Oncol. 2020; 27: 1898-1899
- The association of the serum levels of myostatin, follistatin, and interleukin-6 with sarcopenia, and their impacts on survival in patients with hepatocellular carcinoma.Clin Mol Hepatol. 2020; 26
- Muscle–organ crosstalk: the emerging roles of myokines.Endocr Rev. 2021; 42: 97-99
- Management of muscle wasting in cancer-associated cachexia. vol. 92. Cancer, 2001
- Sarcopenia impairs prognosis of patients with hepatocellular carcinoma: the role of liver functional reserve and tumor-related factors in loss of skeletal muscle volume.Nutrients. 2017; 9
- Preoperative sarcopenia negatively impacts postoperative outcomes following major hepatectomy with extrahepatic bile duct resection.World J Surg. 2015; 39: 1494-1500
- The association of textbook outcome and long-term survival after esophagectomy for esophageal cancer.Ann Thorac Surg. 2021; 112: 1134-1141
- Prognostic significance of surgery-induced sarcopenia in the survival of gastric cancer patients: a sex-specific analysis.J Cachexia Sarcopenia Muscle. 2021; 12: 1897-1907
- Surgical treatments of hepatobiliary cancers.Hepatology. 2021; 73: 128-136
- A new strategy of laparoscopic anatomical hemihepatectomy guided by the middle hepatic vein combined with transhepatic duct lithotomy for complex hemihepatolithiasis: a propensity score matching study.Surgery. 2021; 170: 18-29
- Total laparoscopic partial hepatectomy versus open partial hepatectomy for primary left-sided hepatolithiasis: a propensity, long-term follow-up analysis at a single center.Surgery. 2018; 163: 714-720
- Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease.Hepatology. 2018; 67: 123-133
- Relationship between presarcopenia and event occurrence in patients with primary hepatocellular carcinoma.Sci Rep. 2020; 10: 10186
- Impact of sarcopenic obesity on outcomes in patients undergoing hepatectomy for hepatocellular carcinoma.Ann Surg. 2019; 269: 924-931
Article info
Publication history
Published online: December 22, 2022
Accepted:
December 18,
2022
Received in revised form:
December 10,
2022
Received:
August 17,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
☆This manuscript is an original article, and is not based on a previous communication to a society or meeting.
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
