Cargando…

Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma

BACKGROUND: Body composition alterations are frequent in patients with cancer or chronic liver disease, but their prognostic value remains unclear in many cancer entities. OBJECTIVE: We investigated the impact of disease aetiology and body composition after surgery for intrahepatic cholangiocarcinom...

Descripción completa

Detalles Bibliográficos
Autores principales: Lurje, Isabella, Uluk, Deniz, Pavicevic, Sandra, Phan, Minh Duc, Eurich, Dennis, Fehrenbach, Uli, Geisel, Dominik, Auer, Timo Alexander, Pelzer, Uwe, Modest, Dominik Paul, Raschzok, Nathanael, Sauer, Igor Maximilian, Schöning, Wenzel, Tacke, Frank, Pratschke, Johann, Lurje, Georg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524050/
https://www.ncbi.nlm.nih.gov/pubmed/37496321
http://dx.doi.org/10.1002/cam4.6374
_version_ 1785110667375673344
author Lurje, Isabella
Uluk, Deniz
Pavicevic, Sandra
Phan, Minh Duc
Eurich, Dennis
Fehrenbach, Uli
Geisel, Dominik
Auer, Timo Alexander
Pelzer, Uwe
Modest, Dominik Paul
Raschzok, Nathanael
Sauer, Igor Maximilian
Schöning, Wenzel
Tacke, Frank
Pratschke, Johann
Lurje, Georg
author_facet Lurje, Isabella
Uluk, Deniz
Pavicevic, Sandra
Phan, Minh Duc
Eurich, Dennis
Fehrenbach, Uli
Geisel, Dominik
Auer, Timo Alexander
Pelzer, Uwe
Modest, Dominik Paul
Raschzok, Nathanael
Sauer, Igor Maximilian
Schöning, Wenzel
Tacke, Frank
Pratschke, Johann
Lurje, Georg
author_sort Lurje, Isabella
collection PubMed
description BACKGROUND: Body composition alterations are frequent in patients with cancer or chronic liver disease, but their prognostic value remains unclear in many cancer entities. OBJECTIVE: We investigated the impact of disease aetiology and body composition after surgery for intrahepatic cholangiocarcinoma (iCCA), a rare and understudied cancer entity in European and North American cohorts. METHODS: Computer tomography‐based assessment of body composition at the level of the third lumbar vertebra was performed in 173 patients undergoing curative‐intent liver resection for iCCA at the Department of Surgery, Charité – Universitätsmedizin Berlin. Muscle mass and ‐composition as well as subcutaneous and visceral adipose tissue quantity were determined semi‐automatically. (Secondary) sarcopenia, sarcopenic obesity, myosteatosis, visceral and subcutaneous obesity were correlated to clinicopathological data. RESULTS: Sarcopenia was associated with post‐operative morbidity (intraoperative transfusions [p = 0.027], Clavien–Dindo ≥ IIIb complications [p = 0.030], post‐operative comprehensive complication index, CCI [p < 0.001]). Inferior overall survival was noted in patients with myosteatosis (33 vs. 23 months, p = 0.020). Fifty‐eight patients (34%) had metabolic (dysfunction)‐associated fatty liver disease (MAFLD) and had a significantly higher incidence of sarcopenic (p = 0.006), visceral (p < 0.001) and subcutaneous obesity (p < 0.001). Patients with MAFLD had longer time‐to‐recurrence (median: 38 vs. 12 months, p = 0.025, log‐rank test). Multivariable cox regression analysis confirmed only clinical, and not body, composition parameters (age > 65, fresh frozen plasma transfusions) as independently prognostic for overall survival. CONCLUSION: This study evidenced a high prevalence of MAFLD in iCCA, suggesting its potential contribution to disease aetiology. Alterations of muscle mass and adipose tissue were more frequent in patients with MAFLD.
format Online
Article
Text
id pubmed-10524050
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-105240502023-09-28 Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma Lurje, Isabella Uluk, Deniz Pavicevic, Sandra Phan, Minh Duc Eurich, Dennis Fehrenbach, Uli Geisel, Dominik Auer, Timo Alexander Pelzer, Uwe Modest, Dominik Paul Raschzok, Nathanael Sauer, Igor Maximilian Schöning, Wenzel Tacke, Frank Pratschke, Johann Lurje, Georg Cancer Med RESEARCH ARTICLES BACKGROUND: Body composition alterations are frequent in patients with cancer or chronic liver disease, but their prognostic value remains unclear in many cancer entities. OBJECTIVE: We investigated the impact of disease aetiology and body composition after surgery for intrahepatic cholangiocarcinoma (iCCA), a rare and understudied cancer entity in European and North American cohorts. METHODS: Computer tomography‐based assessment of body composition at the level of the third lumbar vertebra was performed in 173 patients undergoing curative‐intent liver resection for iCCA at the Department of Surgery, Charité – Universitätsmedizin Berlin. Muscle mass and ‐composition as well as subcutaneous and visceral adipose tissue quantity were determined semi‐automatically. (Secondary) sarcopenia, sarcopenic obesity, myosteatosis, visceral and subcutaneous obesity were correlated to clinicopathological data. RESULTS: Sarcopenia was associated with post‐operative morbidity (intraoperative transfusions [p = 0.027], Clavien–Dindo ≥ IIIb complications [p = 0.030], post‐operative comprehensive complication index, CCI [p < 0.001]). Inferior overall survival was noted in patients with myosteatosis (33 vs. 23 months, p = 0.020). Fifty‐eight patients (34%) had metabolic (dysfunction)‐associated fatty liver disease (MAFLD) and had a significantly higher incidence of sarcopenic (p = 0.006), visceral (p < 0.001) and subcutaneous obesity (p < 0.001). Patients with MAFLD had longer time‐to‐recurrence (median: 38 vs. 12 months, p = 0.025, log‐rank test). Multivariable cox regression analysis confirmed only clinical, and not body, composition parameters (age > 65, fresh frozen plasma transfusions) as independently prognostic for overall survival. CONCLUSION: This study evidenced a high prevalence of MAFLD in iCCA, suggesting its potential contribution to disease aetiology. Alterations of muscle mass and adipose tissue were more frequent in patients with MAFLD. John Wiley and Sons Inc. 2023-07-26 /pmc/articles/PMC10524050/ /pubmed/37496321 http://dx.doi.org/10.1002/cam4.6374 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Lurje, Isabella
Uluk, Deniz
Pavicevic, Sandra
Phan, Minh Duc
Eurich, Dennis
Fehrenbach, Uli
Geisel, Dominik
Auer, Timo Alexander
Pelzer, Uwe
Modest, Dominik Paul
Raschzok, Nathanael
Sauer, Igor Maximilian
Schöning, Wenzel
Tacke, Frank
Pratschke, Johann
Lurje, Georg
Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
title Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
title_full Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
title_fullStr Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
title_full_unstemmed Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
title_short Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
title_sort body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524050/
https://www.ncbi.nlm.nih.gov/pubmed/37496321
http://dx.doi.org/10.1002/cam4.6374
work_keys_str_mv AT lurjeisabella bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT ulukdeniz bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT pavicevicsandra bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT phanminhduc bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT eurichdennis bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT fehrenbachuli bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT geiseldominik bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT auertimoalexander bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT pelzeruwe bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT modestdominikpaul bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT raschzoknathanael bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT sauerigormaximilian bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT schoningwenzel bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT tackefrank bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT pratschkejohann bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma
AT lurjegeorg bodycompositionisassociatedwithdiseaseaetiologyandprognosisinpatientsundergoingresectionofintrahepaticcholangiocarcinoma