Sarcopenia Adversely Impacts Postoperative Complications Following Resection or Transplantation in Patients with Primary Liver Tumors

Vicente Valero, Neda Amini, Gaya Spolverato, Matthew J. Weiss, Kenzo Hirose, Nabil N. Dagher, Christopher L. Wolfgang, Andrew A. Cameron, Benjamin Philosophe, Ihab R. Kamel, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background: Sarcopenia is a surrogate marker of patient frailty that estimates the physiologic reserve of an individual patient. We sought to investigate the impact of sarcopenia on short- and long-term outcomes in patients having undergone surgical intervention for primary hepatic malignancies.Methods: Ninety-six patients who underwent hepatic resection or liver transplantation for HCC or ICC at the John Hopkins Hospital between 2000 and 2013 met inclusion criteria. Sarcopenia was assessed by the measurement of total psoas major volume (TPV) and total psoas area (TPA). The impact of sarcopenia on perioperative complications and survival was assessed.Results: Mean age was 61.9 years and most patients were men (61.4 %). Mean adjusted TPV was lower in women (23.3 cm3/m) versus men (34.9 cm3/m) (P < 0.01); 47 patients (48.9 %) had sarcopenia. The incidence of a postoperative complication was 40.4 % among patients with sarcopenia versus 18.4 % among patients who did not have sarcopenia (P = 0.01). Of note, all Clavien grade ≥3 complications (n = 11, 23.4 %) occurred in the sarcopenic group. On multivariable analysis, the presence of sarcopenia was an independent predictive factor of postoperative complications (OR = 3.06). Sarcopenia was not associated with long-term survival (HR = 1.23; P = 0.51).Conclusions: Sarcopenia, as assessed by TPV, was an independent factor predictive of postoperative complications following surgical intervention for primary hepatic malignancies.

Original languageEnglish (US)
Pages (from-to)272-281
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number2
DOIs
StatePublished - Jan 1 2015

Keywords

  • Hepatocellular carcinoma
  • Intrahepatic cholangiocarcinoma
  • Liver cancer
  • Liver surgery
  • Outcomes
  • Sarcopenia

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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