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Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study

The aim of the study was to clarify the impact of reduced skeletal muscle volume on the morbidity of patients who underwent esophagectomy for esophageal cancer. Malnutrition and reduced skeletal muscle volume, that is, presarcopenia, are reportedly associated with a high frequency of postoperative c...

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Autores principales: Nagata, Ken, Tsujimoto, Hironori, Nagata, Hiromi, Harada, Manabu, Ito, Nozomi, Kanematsu, Kyohei, Nomura, Shinsuke, Horiguchi, Hiroyuki, Hiraki, Shuichi, Hase, Kazuo, Yamamoto, Junji, Ueno, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078756/
https://www.ncbi.nlm.nih.gov/pubmed/30045268
http://dx.doi.org/10.1097/MD.0000000000011450
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author Nagata, Ken
Tsujimoto, Hironori
Nagata, Hiromi
Harada, Manabu
Ito, Nozomi
Kanematsu, Kyohei
Nomura, Shinsuke
Horiguchi, Hiroyuki
Hiraki, Shuichi
Hase, Kazuo
Yamamoto, Junji
Ueno, Hideki
author_facet Nagata, Ken
Tsujimoto, Hironori
Nagata, Hiromi
Harada, Manabu
Ito, Nozomi
Kanematsu, Kyohei
Nomura, Shinsuke
Horiguchi, Hiroyuki
Hiraki, Shuichi
Hase, Kazuo
Yamamoto, Junji
Ueno, Hideki
author_sort Nagata, Ken
collection PubMed
description The aim of the study was to clarify the impact of reduced skeletal muscle volume on the morbidity of patients who underwent esophagectomy for esophageal cancer. Malnutrition and reduced skeletal muscle volume, that is, presarcopenia, are reportedly associated with a high frequency of postoperative complications after esophagectomy. However, it remains unclear whether the reduction of skeletal muscle volume following esophagectomy may affect clinical outcomes including pneumonia occurred beyond the preoperative period. From February 2009 to June 2015, in 123 patients, we retrospectively evaluated the postoperative changes of the psoas muscle index (PI) on computed tomography and assessed their impact on the incidence of pneumonia after esophagectomy. There was a significant reduction in the PI 6 months after surgery compared to the preoperative value. The incidence of pneumonia as of 6 months after surgery was 23.6%, which was higher in patients of advanced age (P = .02), those with a lower body mass index (P = .02), and those with a greater reduction of PI during 6 months after surgery (P = .03). It was not associated with preoperative nutritional data, pulmonary function, operative procedure, and preoperative PI. Multivariate analysis demonstrated that age and postoperative PI reduction were independently associated with the incidence of pneumonia 6 months after surgery (hazard ratio [HR] = 2.92, 95% confidence interval [CI] 1.16–7.32, P = .02; HR = 3.25, 95% CI 1.15–9.15, P = .03, respectively). Patients with pneumonia 6 months after surgery had significantly poorer overall survival than those without pneumonia at that time. Postoperative reduction of skeletal muscle volume was independently associated with the occurrence of pneumonia beyond the preoperative period, which might indicate the importance of a postoperative nutritional support after perioperative period in esophageal cancer patients.
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spelling pubmed-60787562018-08-13 Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study Nagata, Ken Tsujimoto, Hironori Nagata, Hiromi Harada, Manabu Ito, Nozomi Kanematsu, Kyohei Nomura, Shinsuke Horiguchi, Hiroyuki Hiraki, Shuichi Hase, Kazuo Yamamoto, Junji Ueno, Hideki Medicine (Baltimore) Research Article The aim of the study was to clarify the impact of reduced skeletal muscle volume on the morbidity of patients who underwent esophagectomy for esophageal cancer. Malnutrition and reduced skeletal muscle volume, that is, presarcopenia, are reportedly associated with a high frequency of postoperative complications after esophagectomy. However, it remains unclear whether the reduction of skeletal muscle volume following esophagectomy may affect clinical outcomes including pneumonia occurred beyond the preoperative period. From February 2009 to June 2015, in 123 patients, we retrospectively evaluated the postoperative changes of the psoas muscle index (PI) on computed tomography and assessed their impact on the incidence of pneumonia after esophagectomy. There was a significant reduction in the PI 6 months after surgery compared to the preoperative value. The incidence of pneumonia as of 6 months after surgery was 23.6%, which was higher in patients of advanced age (P = .02), those with a lower body mass index (P = .02), and those with a greater reduction of PI during 6 months after surgery (P = .03). It was not associated with preoperative nutritional data, pulmonary function, operative procedure, and preoperative PI. Multivariate analysis demonstrated that age and postoperative PI reduction were independently associated with the incidence of pneumonia 6 months after surgery (hazard ratio [HR] = 2.92, 95% confidence interval [CI] 1.16–7.32, P = .02; HR = 3.25, 95% CI 1.15–9.15, P = .03, respectively). Patients with pneumonia 6 months after surgery had significantly poorer overall survival than those without pneumonia at that time. Postoperative reduction of skeletal muscle volume was independently associated with the occurrence of pneumonia beyond the preoperative period, which might indicate the importance of a postoperative nutritional support after perioperative period in esophageal cancer patients. Wolters Kluwer Health 2018-07-27 /pmc/articles/PMC6078756/ /pubmed/30045268 http://dx.doi.org/10.1097/MD.0000000000011450 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Nagata, Ken
Tsujimoto, Hironori
Nagata, Hiromi
Harada, Manabu
Ito, Nozomi
Kanematsu, Kyohei
Nomura, Shinsuke
Horiguchi, Hiroyuki
Hiraki, Shuichi
Hase, Kazuo
Yamamoto, Junji
Ueno, Hideki
Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study
title Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study
title_full Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study
title_fullStr Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study
title_full_unstemmed Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study
title_short Impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: A retrospective study
title_sort impact of reduced skeletal muscle volume on clinical outcome after esophagectomy for esophageal cancer: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078756/
https://www.ncbi.nlm.nih.gov/pubmed/30045268
http://dx.doi.org/10.1097/MD.0000000000011450
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