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Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor
BACKGROUND: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly i...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320551/ https://www.ncbi.nlm.nih.gov/pubmed/32591002 http://dx.doi.org/10.1186/s12957-020-01908-6 |
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author | Maeda, Naoaki Shirakawa, Yasuhiro Tanabe, Shunsuke Sakurama, Kazufumi Noma, Kazuhiro Fujiwara, Toshiyoshi |
author_facet | Maeda, Naoaki Shirakawa, Yasuhiro Tanabe, Shunsuke Sakurama, Kazufumi Noma, Kazuhiro Fujiwara, Toshiyoshi |
author_sort | Maeda, Naoaki |
collection | PubMed |
description | BACKGROUND: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery. METHODS: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and February 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and 3 days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model. RESULTS: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The 3-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group. CONCLUSION: Skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis. |
format | Online Article Text |
id | pubmed-7320551 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73205512020-06-29 Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor Maeda, Naoaki Shirakawa, Yasuhiro Tanabe, Shunsuke Sakurama, Kazufumi Noma, Kazuhiro Fujiwara, Toshiyoshi World J Surg Oncol Research BACKGROUND: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery. METHODS: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and February 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and 3 days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model. RESULTS: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The 3-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group. CONCLUSION: Skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis. BioMed Central 2020-06-26 /pmc/articles/PMC7320551/ /pubmed/32591002 http://dx.doi.org/10.1186/s12957-020-01908-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Maeda, Naoaki Shirakawa, Yasuhiro Tanabe, Shunsuke Sakurama, Kazufumi Noma, Kazuhiro Fujiwara, Toshiyoshi Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
title | Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
title_full | Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
title_fullStr | Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
title_full_unstemmed | Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
title_short | Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
title_sort | skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320551/ https://www.ncbi.nlm.nih.gov/pubmed/32591002 http://dx.doi.org/10.1186/s12957-020-01908-6 |
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