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Textbook outcomes of hepatocellular carcinoma patients with sarcopenia: A multicenter analysis

  • Author Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
    Di-Hang Wu
    Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
    Cheng-Yu Liao
    Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
    Dan-Feng Wang
    Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China
    Search for articles by this author
  • Long Huang
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Ge Li
    Affiliations
    Fujian Medical University Union Hospital, Fuzhou, China
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  • Jiang-Zhi Chen
    Affiliations
    Fujian Medical University Union Hospital, Fuzhou, China
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  • Liang Wang
    Affiliations
    The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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  • Tian-Sheng Lin
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Jian-Lin Lai
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Song-Qiang Zhou
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Fu-Nan Qiu
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Zhi-Bo Zhang
    Affiliations
    The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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  • Yan-Ling Chen
    Affiliations
    Fujian Medical University Union Hospital, Fuzhou, China
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  • Yao-Dong Wang
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
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  • Xiao-Chun Zheng
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, China
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  • Yi-Feng Tian
    Correspondence
    Corresponding author.Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, 350001, China.
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
    Search for articles by this author
  • Shi Chen
    Correspondence
    Corresponding author.Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, 350001, China.
    Affiliations
    Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Di-Hang Wu, Cheng-Yu Liao and Dan-Feng Wang contributed equally to this work.
Published:December 22, 2022DOI:https://doi.org/10.1016/j.ejso.2022.12.009

      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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