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Sarcopenia predicts reduced liver growth and reduced resectability in patients undergoing portal vein embolization before liver resection-A DRAGON collaborative analysis of 306 patients

Heil, Jan (author)
Univ Zurich, Switzerland; Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Gen Visceral & Transplant Surg, Frankfurt, Germany
Heid, Franziska (author)
Univ Zurich, Switzerland; Cantonal Hosp Winterthur, Switzerland
Bechstein, Wolf O. (author)
Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Gen Visceral & Transplant Surg, Frankfurt, Germany
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Björnsson, Bergthor (author)
Karolinska Institutet,Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
Brismar, Torkel B. (author)
Karolinska Inst, Sweden
Carling, Ulrik (author)
Oslo Univ Hosp, Norway
Erdmann, Joris (author)
Univ Amsterdam, Netherlands
Fretland, Asmund A. (author)
Oslo Univ Hosp, Norway; Oslo Univ Hosp, Norway
Grunhagen, Dirk (author)
Erasmus Univ, Netherlands
Hana, Renato A. (author)
McGill Gen Hosp, Canada
Hohmann, Joachim (author)
Cantonal Hosp Winterthur, Switzerland; Univ Basel, Switzerland
Linke, Richard (author)
Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Gen Visceral & Transplant Surg, Frankfurt, Germany
Meyer, Yannick (author)
Erasmus Univ, Netherlands
Nawawi, Abrar (author)
McGill Hlth Ctr Res Inst, Canada
Olthof, Pim B. (author)
Univ Amsterdam, Netherlands; Erasmus Univ, Netherlands
Sandström, Per (author)
Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
Schnitzbauer, Andreas A. (author)
Goethe Univ Frankfurt, Univ Hosp Frankfurt, Dept Gen Visceral & Transplant Surg, Frankfurt, Germany
Sparrelid, Ernesto (author)
Karolinska Institutet
Verhoef, Cornelis (author)
Erasmus Univ, Netherlands
Metrakos, Peter (author)
Department of Surgery, McGill Health Center Research Institute, Cancer Program, Montreal, Canada
Schadde, Erik (author)
Univ Zurich, Switzerland; Rush Univ, IL USA
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 (creator_code:org_t)
ELSEVIER SCI LTD, 2022
2022
English.
In: HPB. - : ELSEVIER SCI LTD. - 1365-182X .- 1477-2574. ; 24:3, s. 413-421
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: After portal vein embolization (PVE) 30% fail to achieve liver resection. Malnutrition is a modifiable risk factor and can be assessed by radiological indices. This study investigates, if sarcopenia affects resectability and kinetic growth rate (KGR) after PVE. Methods: A retrospective study was performed of the outcome of PVE at 8 centres of the DRAGON collaborative from 2010 to 2019. All malignant tumour types were included. Sarcopenia was defined using gender, body mass and skeletal muscle index. First imaging after PVE was used for liver volumetry. Primary and secondary endpoints were resectability and KGR. Risk factors impacting liver growth were assessed in a multivariable analysis. Results: Eight centres identified 368 patients undergoing PVE. 62 patients (17%) had to be excluded due to unavailability of data. Among the 306 included patients, 112 (37%) were non-sarcopenic and 194 (63%) were sarcopenic. Sarcopenic patients had a 21% lower resectability rate (87% vs. 66%, p < 0.001) and a 23% reduced KGR (p = 0.02) after PVE. In a multivariable model dichotomized for KGR >2.3% standardized FLR (sFLR)/week, only sarcopenia and sFLR before embolization correlated with KGR. Conclusion: In this largest study of risk factors, sarcopenia was associated with reduced resectability and KGR in patients undergoing PVE.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

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art (subject category)

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