Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma

Introduction: Surgery represents the only curative treatment option for patients with cholangiocarcinoma. However, complete tumor resection requires extensive surgery in many patients, and it is still debated which patients represent the ideal candidates for such therapy in terms of overall survival...

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Autores principales:	Markus Sebastian Jördens, Lisa Heinrichs, Sven H. Loosen, Linda Wittig, Verena Keitel, David Schöler, Maximilian Schulze-Hagen, Christina Loberg, Gerald Antoch, Wolfram Trudo Knoefel, Tom Luedde, Georg Fluegen, Christoph Roderburg
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	sarcopenia cholangiocellular adenocarcinoma CCA surgery prognostic marker Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1666d21967f14c51a440a82532143ea0
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spelling	oai:doaj.org-article:1666d21967f14c51a440a82532143ea02021-11-11T15:29:01ZSarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma10.3390/cancers132153592072-6694https://doaj.org/article/1666d21967f14c51a440a82532143ea02021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5359https://doaj.org/toc/2072-6694Introduction: Surgery represents the only curative treatment option for patients with cholangiocarcinoma. However, complete tumor resection requires extensive surgery in many patients, and it is still debated which patients represent the ideal candidates for such therapy in terms of overall survival. Sarcopenia has been associated with an adverse outcome for various malignancies, but its role in the context of patients undergoing tumor resection for cholangiocellular adenocarcinoma (CCA) is only poorly understood. Here, we evaluated the role of sarcopenia in the outcome of CCA patients undergoing radical tumor resection. Methods: Pre-operative CT scans were used to assess the skeletal muscle index (L3SMI) as well as the psoas muscle index (L3PMI) in <i>n</i> = 76 patients receiving curative intended surgery for CCA. L3SMI and L3PMI were correlated with clinical and laboratory markers. Results: Patients with a skeletal muscle index or psoas muscle index above an established ideal cut-off (54.26 and 1.685 cm<sup>2</sup>/m<sup>2</sup>) showed a significantly better overall survival in Kaplan–Meier Curve analyses (L3SMI: 1814 days (95% CI: 520–3108) vs. 467 days (95% CI: 225–709) days; log rank X<sup>2</sup>(1) = 7.18, <i>p</i> = 0.007; L3PMI: 608 days (95% CI: 297–919) vs. 87 days (95% CI: 33–141), log rank X<sup>2</sup>(1) = 18.71; <i>p</i> < 0.001). Notably, these findings, especially for L3PMI, were confirmed in univariate (L3SMI: HR 0.962 (0.936–0.989); <i>p</i> = 0.006; L3PMI: HR 0.529 (0.366–0.766); <i>p</i> ≤ 0.001) and multivariate Cox regression analyses. Further analyses revealed that the prognostic value of both L3SMI and L3PMI was restricted to male patients, while in female patients survival was independent of the individual muscle mass. Conclusion: Measurement of muscle mass from preoperative CT scans represents an easily obtainable tool to estimate patient prognosis following curative surgery. The prognostic value was restricted to male patients, while in female patients these parameters did not reflect the patient outcome.Markus Sebastian JördensLisa HeinrichsSven H. LoosenLinda WittigVerena KeitelDavid SchölerMaximilian Schulze-HagenChristina LobergGerald AntochWolfram Trudo KnoefelTom LueddeGeorg FluegenChristoph RoderburgMDPI AGarticlesarcopeniacholangiocellular adenocarcinomaCCAsurgeryprognostic markerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5359, p 5359 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sarcopenia cholangiocellular adenocarcinoma CCA surgery prognostic marker Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	sarcopenia cholangiocellular adenocarcinoma CCA surgery prognostic marker Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Markus Sebastian Jördens Lisa Heinrichs Sven H. Loosen Linda Wittig Verena Keitel David Schöler Maximilian Schulze-Hagen Christina Loberg Gerald Antoch Wolfram Trudo Knoefel Tom Luedde Georg Fluegen Christoph Roderburg Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma
description	Introduction: Surgery represents the only curative treatment option for patients with cholangiocarcinoma. However, complete tumor resection requires extensive surgery in many patients, and it is still debated which patients represent the ideal candidates for such therapy in terms of overall survival. Sarcopenia has been associated with an adverse outcome for various malignancies, but its role in the context of patients undergoing tumor resection for cholangiocellular adenocarcinoma (CCA) is only poorly understood. Here, we evaluated the role of sarcopenia in the outcome of CCA patients undergoing radical tumor resection. Methods: Pre-operative CT scans were used to assess the skeletal muscle index (L3SMI) as well as the psoas muscle index (L3PMI) in <i>n</i> = 76 patients receiving curative intended surgery for CCA. L3SMI and L3PMI were correlated with clinical and laboratory markers. Results: Patients with a skeletal muscle index or psoas muscle index above an established ideal cut-off (54.26 and 1.685 cm<sup>2</sup>/m<sup>2</sup>) showed a significantly better overall survival in Kaplan–Meier Curve analyses (L3SMI: 1814 days (95% CI: 520–3108) vs. 467 days (95% CI: 225–709) days; log rank X<sup>2</sup>(1) = 7.18, <i>p</i> = 0.007; L3PMI: 608 days (95% CI: 297–919) vs. 87 days (95% CI: 33–141), log rank X<sup>2</sup>(1) = 18.71; <i>p</i> < 0.001). Notably, these findings, especially for L3PMI, were confirmed in univariate (L3SMI: HR 0.962 (0.936–0.989); <i>p</i> = 0.006; L3PMI: HR 0.529 (0.366–0.766); <i>p</i> ≤ 0.001) and multivariate Cox regression analyses. Further analyses revealed that the prognostic value of both L3SMI and L3PMI was restricted to male patients, while in female patients survival was independent of the individual muscle mass. Conclusion: Measurement of muscle mass from preoperative CT scans represents an easily obtainable tool to estimate patient prognosis following curative surgery. The prognostic value was restricted to male patients, while in female patients these parameters did not reflect the patient outcome.
format	article
author	Markus Sebastian Jördens Lisa Heinrichs Sven H. Loosen Linda Wittig Verena Keitel David Schöler Maximilian Schulze-Hagen Christina Loberg Gerald Antoch Wolfram Trudo Knoefel Tom Luedde Georg Fluegen Christoph Roderburg
author_facet	Markus Sebastian Jördens Lisa Heinrichs Sven H. Loosen Linda Wittig Verena Keitel David Schöler Maximilian Schulze-Hagen Christina Loberg Gerald Antoch Wolfram Trudo Knoefel Tom Luedde Georg Fluegen Christoph Roderburg
author_sort	Markus Sebastian Jördens
title	Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma
title_short	Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma
title_full	Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma
title_fullStr	Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma
title_full_unstemmed	Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma
title_sort	sarcopenia predicts cancer mortality in male but not in female patients undergoing surgery for cholangiocellular carcinoma
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1666d21967f14c51a440a82532143ea0
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Sarcopenia Predicts Cancer Mortality in Male but Not in Female Patients Undergoing Surgery for Cholangiocellular Carcinoma

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