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Journal of Gastrointestinal Surgery

, Volume 19, Issue 2, pp 272–281 | Cite as

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

  • Vicente ValeroIII
  • 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. PawlikEmail author
Original Article

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.

Keywords

Sarcopenia Liver cancer Hepatocellular carcinoma Intrahepatic cholangiocarcinoma Outcomes Liver surgery 

Supplementary material

11605_2014_2680_MOESM1_ESM.docx (24 kb)
ESM 1 (DOC 23 kb)

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Copyright information

© The Society for Surgery of the Alimentary Tract 2014

Authors and Affiliations

  • Vicente ValeroIII
    • 1
  • Neda Amini
    • 1
  • Gaya Spolverato
    • 1
  • Matthew J. Weiss
    • 1
  • Kenzo Hirose
    • 1
  • Nabil N. Dagher
    • 1
  • Christopher L. Wolfgang
    • 1
  • Andrew A. Cameron
    • 1
  • Benjamin Philosophe
    • 1
  • Ihab R. Kamel
    • 2
  • Timothy M. Pawlik
    • 1
    Email author
  1. 1.Department of SurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of RadiologyThe Johns Hopkins University School of MedicineBaltimoreUSA

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