术前肌肉减少症对直肠癌的短期和长期预后有负面影响:倾向评分匹配分析

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Kensuke Kaneko, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Soichiro Ishihara
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引用次数: 0

摘要

目的:骨骼肌减少症与各种癌症术后不良预后相关;然而,有关直肠癌的证据有限。因此,本研究考察了骨骼肌质量对直肠癌短期和长期预后的影响。材料和方法本研究纳入了2003年至2021年间在东京大学医院接受根治性切除术的787例I-IV期直肠癌患者。我们进行了倾向评分匹配分析以减轻混杂偏差。测量第三腰大肌质量来确定肌肉减少症。结果787例患者中有350例(44.5%)为肌肉减少症。匹配后,对532例患者进行分析。肌少症组和非肌少症组患者特征相似;然而,体重指数却有所不同。骨骼肌减少组术后各级别并发症发生率均显著高于对照组(33.1% vs 24.8%;P = 0.035),≥2级(29.3% vs 21.8%;P = 0.047),吻合口瘘(1.9% vs 0%;P = 0.0082)高于非肌少症组。肌少症组的5年总生存率明显低于非肌少症组(85.3% vs 91.8%, p = 0.019)。两组无病生存率相似(p = 0.40)。在全队列分析中,肌肉减少症是术后总并发症的独立危险因素(优势比1.41,p = 0.042)。结论直肠癌患者术前肌肉减少,术后总并发症多,吻合口瘘多,生存率低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Preoperative sarcopenia negatively impacts short- and long-term outcomes of rectal cancer: A propensity score-matched analysis

Preoperative sarcopenia negatively impacts short- and long-term outcomes of rectal cancer: A propensity score-matched analysis

Aim

Sarcopenia is associated with poor postoperative outcomes in various cancers; however, limited evidence is available for rectal cancer. Therefore, the present study examined the effects of skeletal muscle mass on the short- and long-term outcomes of rectal cancer.

Materials and Methods

A total of 787 Stage I–IV rectal cancer patients who underwent curative resection between 2003 and 2021 at The University of Tokyo Hospital were included. We conducted a propensity score-matched analysis to mitigate confounding bias. The third lumber psoas muscle mass was measured to define sarcopenia.

Results

Among 787 patients, 350 (44.5%) were classified as having sarcopenia. After matching, 532 patients were analyzed. Patient characteristics in the sarcopenia and nonsarcopenia groups were similar; however, the body mass index differed. The sarcopenia group had significantly higher rates of postoperative complications of all grades (33.1% vs 24.8%; p = 0.035), of grade ≥2 (29.3% vs 21.8%; p = 0.047), and anastomotic leakage (1.9% vs 0%; p = 0.0082) than the nonsarcopenia group. The 5-y overall survival rate was significantly lower in the sarcopenia group than in the nonsarcopenia group (85.3% vs 91.8%, p = 0.019). Disease-free survival was similar between the groups (p = 0.40). In the total cohort analysis, sarcopenia was an independent risk factor for total postoperative complications (odds ratio 1.41, p = 0.042).

Conclusion

Preoperative sarcopenia is associated with more total postoperative complications, more anastomotic leakage, and worse survival in rectal cancer patients.

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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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