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Body composition is associated with postoperative complications in perihilar cholangiocarcinoma.
Wang, Guanwu; Mantas, Anna; Heij, Lara R; Al-Masri, Tarick M; Liu, Dong; Heise, Daniel; Schmitz, Sophia M; Olde Damink, Steven W M; Luedde, Tom; Lang, Sven A; Ulmer, Tom F; Neumann, Ulf P; Bednarsch, Jan.
Afiliación
  • Wang G; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Mantas A; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Heij LR; University of Applied Science Aachen, Aachen, Germany.
  • Al-Masri TM; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Liu D; Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
  • Heise D; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Schmitz SM; University of Applied Science Aachen, Aachen, Germany.
  • Olde Damink SWM; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Luedde T; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Lang SA; Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
  • Ulmer TF; Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
  • Neumann UP; Department of Surgery and Transplantation, University Hospital Essen, Essen, Germany.
  • Bednarsch J; Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
Cancer Med ; 13(1): e6878, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38164056
ABSTRACT

BACKGROUND:

Perihilar cholangiocarcinoma (pCCA) is a malignant tumor of the hepatobiliary system which is still associated with a challenging prognosis. Postoperative complications play a crucial role in determining the overall prognosis of patients with pCCA. Changes in body composition (BC) have been shown to impact the prognosis of various types of tumors. Therefore, our study aimed to investigate the correlation between BC, postoperative complications and oncological outcome in patients with pCCA.

METHODS:

All patients with pCCA who underwent curative-intent surgery for pCCA between 2010 and 2022 were included in this analysis. BC was assessed using preoperative computed tomography and analyzed with the assistance of a 3D Slicer software. Univariate and multivariate binary logistic regression analyses were conducted to examine the relationship between BC and clinical characteristics including various measurements of postoperative complications and Cox regressions and Kaplan-Meier analysis to evaluate oncological risk factors in the study cohort.

RESULTS:

BC was frequently altered in patients undergoing curative-intent liver resection for pCCA (n = 204) with 52.5% of the patients showing obesity, 55.9% sarcopenia, 21.6% sarcopenic obesity, 48.5% myosteatosis, and 69.1% visceral obesity. In multivariate analysis, severe postoperative complications (Clavien-Dindo ≥3b) were associated with body mass index (BMI) (Odds ratio (OR) = 2.001, p = 0.024), sarcopenia (OR = 2.145, p = 0.034), and myosteatosis (OR = 2.097, p = 0.017) as independent predictors. Furthermore, sarcopenia was associated with reduced overall survival (OS) in pCCA patients (sarcopenia vs. no-sarcopenia, 21 months vs. 32 months, p = 0.048 log rank).

CONCLUSIONS:

BC is highly associated with severe postoperative complications in patients with pCCA and shows tendency to be associated impaired overall survival. Preoperative assessment of BC and interventions to improve BC might therefore be key to improve outcome in pCCA patients undergoing surgical therapy.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias de los Conductos Biliares / Composición Corporal / Tumor de Klatskin Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Med Año: 2024 Tipo del documento: Article País de afiliación: Alemania

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias de los Conductos Biliares / Composición Corporal / Tumor de Klatskin Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Med Año: 2024 Tipo del documento: Article País de afiliación: Alemania