Cargando…

The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma

Cholangiocarcinoma (CCA) is a rare but highly aggressive malignancy of the biliary system. Although it is amenable to surgical resection in early disease, outcomes are frequently dismal. Here, we investigated the prevalence of body composition (BC) alterations and their prognostic role for surgical...

Descripción completa

Detalles Bibliográficos
Autores principales: Lurje, Isabella, Czigany, Zoltan, Eischet, Sarah, Bednarsch, Jan, Ulmer, Tom Florian, Isfort, Peter, Strnad, Pavel, Trautwein, Christian, Tacke, Frank, Neumann, Ulf Peter, Lurje, Georg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9426393/
https://www.ncbi.nlm.nih.gov/pubmed/35616275
http://dx.doi.org/10.1002/hep4.2004
_version_ 1784778669057638400
author Lurje, Isabella
Czigany, Zoltan
Eischet, Sarah
Bednarsch, Jan
Ulmer, Tom Florian
Isfort, Peter
Strnad, Pavel
Trautwein, Christian
Tacke, Frank
Neumann, Ulf Peter
Lurje, Georg
author_facet Lurje, Isabella
Czigany, Zoltan
Eischet, Sarah
Bednarsch, Jan
Ulmer, Tom Florian
Isfort, Peter
Strnad, Pavel
Trautwein, Christian
Tacke, Frank
Neumann, Ulf Peter
Lurje, Georg
author_sort Lurje, Isabella
collection PubMed
description Cholangiocarcinoma (CCA) is a rare but highly aggressive malignancy of the biliary system. Although it is amenable to surgical resection in early disease, outcomes are frequently dismal. Here, we investigated the prevalence of body composition (BC) alterations and their prognostic role for surgical patients with intrahepatic (iCCA) and perihilar (pCCA) disease. Patients undergoing curative‐intent surgery for iCCA or pCCA between 2010 and 2019 at University Hospital Aachen were included. Axial computed tomography images were retrospectively assessed with a segmentation tool (3D Slicer) at the level of the third lumbar vertebra to determine lumbar skeletal muscle (SM) index, mean SM radiation attenuation, and visceral fat area. The related BC pathologies sarcopenia, myosteatosis, visceral obesity, and sarcopenic obesity were determined using previously described cutoffs. A total of 189 patients (86 with iCCA, 103 with pCCA) were included. Alterations of BC were highly prevalent in iCCA and pCCA, respectively: sarcopenia, 33% (28/86) and 39% (40/103); myosteatosis, 66% (57/86) and 66% (68/103); visceral obesity, 56% (48/86) and 67% (69/103); sarcopenic obesity, 11% (9/86) and 17% (17/103). Sarcopenia and myosteatosis did not have a significant prognostic role for disease‐free survival (DFS) and overall survival (OS). Patients with iCCA with sarcopenic obesity (n = 9) had significantly shorter OS than patients without sarcopenic obesity (n = 7; log‐rank p = 0.002; median OS, 11 months and 31 months; 1‐year mortality, 55.6% [5/9] and 22% [17/77]; 5‐year mortality, 88.9% [8/9] and 61% [47/77], respectively). In multivariable analysis, only tumor‐related risk factors remained prognostic for DFS and OS. Sarcopenic obesity may affect clinical outcomes after curative‐intent surgery for iCCA, indicating that imaging‐based analysis of BC may hold prognostic value for long‐term survival and could aid preoperative patient selection.
format Online
Article
Text
id pubmed-9426393
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-94263932022-08-31 The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma Lurje, Isabella Czigany, Zoltan Eischet, Sarah Bednarsch, Jan Ulmer, Tom Florian Isfort, Peter Strnad, Pavel Trautwein, Christian Tacke, Frank Neumann, Ulf Peter Lurje, Georg Hepatol Commun Original Articles Cholangiocarcinoma (CCA) is a rare but highly aggressive malignancy of the biliary system. Although it is amenable to surgical resection in early disease, outcomes are frequently dismal. Here, we investigated the prevalence of body composition (BC) alterations and their prognostic role for surgical patients with intrahepatic (iCCA) and perihilar (pCCA) disease. Patients undergoing curative‐intent surgery for iCCA or pCCA between 2010 and 2019 at University Hospital Aachen were included. Axial computed tomography images were retrospectively assessed with a segmentation tool (3D Slicer) at the level of the third lumbar vertebra to determine lumbar skeletal muscle (SM) index, mean SM radiation attenuation, and visceral fat area. The related BC pathologies sarcopenia, myosteatosis, visceral obesity, and sarcopenic obesity were determined using previously described cutoffs. A total of 189 patients (86 with iCCA, 103 with pCCA) were included. Alterations of BC were highly prevalent in iCCA and pCCA, respectively: sarcopenia, 33% (28/86) and 39% (40/103); myosteatosis, 66% (57/86) and 66% (68/103); visceral obesity, 56% (48/86) and 67% (69/103); sarcopenic obesity, 11% (9/86) and 17% (17/103). Sarcopenia and myosteatosis did not have a significant prognostic role for disease‐free survival (DFS) and overall survival (OS). Patients with iCCA with sarcopenic obesity (n = 9) had significantly shorter OS than patients without sarcopenic obesity (n = 7; log‐rank p = 0.002; median OS, 11 months and 31 months; 1‐year mortality, 55.6% [5/9] and 22% [17/77]; 5‐year mortality, 88.9% [8/9] and 61% [47/77], respectively). In multivariable analysis, only tumor‐related risk factors remained prognostic for DFS and OS. Sarcopenic obesity may affect clinical outcomes after curative‐intent surgery for iCCA, indicating that imaging‐based analysis of BC may hold prognostic value for long‐term survival and could aid preoperative patient selection. John Wiley and Sons Inc. 2022-05-26 /pmc/articles/PMC9426393/ /pubmed/35616275 http://dx.doi.org/10.1002/hep4.2004 Text en © 2022 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Lurje, Isabella
Czigany, Zoltan
Eischet, Sarah
Bednarsch, Jan
Ulmer, Tom Florian
Isfort, Peter
Strnad, Pavel
Trautwein, Christian
Tacke, Frank
Neumann, Ulf Peter
Lurje, Georg
The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
title The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
title_full The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
title_fullStr The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
title_full_unstemmed The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
title_short The prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
title_sort prognostic impact of preoperative body composition in perihilar and intrahepatic cholangiocarcinoma
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9426393/
https://www.ncbi.nlm.nih.gov/pubmed/35616275
http://dx.doi.org/10.1002/hep4.2004
work_keys_str_mv AT lurjeisabella theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT cziganyzoltan theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT eischetsarah theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT bednarschjan theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT ulmertomflorian theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT isfortpeter theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT strnadpavel theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT trautweinchristian theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT tackefrank theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT neumannulfpeter theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT lurjegeorg theprognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT lurjeisabella prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT cziganyzoltan prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT eischetsarah prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT bednarschjan prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT ulmertomflorian prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT isfortpeter prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT strnadpavel prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT trautweinchristian prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT tackefrank prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT neumannulfpeter prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma
AT lurjegeorg prognosticimpactofpreoperativebodycompositioninperihilarandintrahepaticcholangiocarcinoma