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Low Thoracic Skeletal Muscle Area Predicts Morbidity After Pneumonectomy For Lung Cancer.

M. Madariaga, Fabian M Troschel Cand Med, Till D Best Cand Med, Sheila J Knoll, H. Gaissert, F. Fintelmann
Published 2019 · Medicine

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BACKGROUND Sarcopenia represented by low psoas muscle area is associated with increased hospital length of stay (LOS), postoperative complications and mortality. We studied whether thoracic skeletal muscle area (TSMA) derived from computed tomography (CT) predicts morbidity after pneumonectomy for lung cancer. METHODS Consecutive patients who underwent pneumonectomy for lung cancer from 2005 to 2017 were retrospectively analyzed. TSMA was defined as the sum of muscle area at the level of the 8th and the 12th thoracic vertebral bodies on preoperative CT. Patients were stratified into sex-specific TSMA quartiles for univariate time-to-event analyses. The effect of continuous TSMA measurements on operative complications, hospital and ICU LOS, discharge disposition and hospital readmission within 90 days was estimated using multivariable models adjusted for age, sex, BMI, %FEV1, Zubrod score and pneumonectomy type RESULTS: Standard (n=102, 78.5%) or high-risk pneumonectomy (n=28, 21.5%: extra-pleural (n=3, 2.3%), carinal (n=9, 6.9%), completion (n=16, 12.3%)) was performed in 130 patients (60.8±10.6 years; 43.1% female). Major complications occurred in 33.1% (43/130) and readmission in 17.7% (23/130) of patients. In multivariable models, patients with high TSMA experienced fewer overall (OR 0.87, p=0.04) and cardiopulmonary (OR 0.86, p=0.04) complications, and fewer readmissions (OR 0.78, p=0.01). Associations with ICU LOS (HR 1.08, p=0.051) and hospital LOS (HR 1.05, p=0.18) did not reach significance. CONCLUSIONS TSMA predicts adverse outcome after pneumonectomy for lung cancer. This marker, readily derived from standard chest CT, identifies patients at increased risk for postoperative complications and may help select patients appropriate for focused rehabilitation prior to pneumonectomy.
This paper references
10.1016/j.athoracsur.2018.01.013
Thoracic Skeletal Muscle Is Associated With Adverse Outcomes After Lobectomy for Lung Cancer.
F. Fintelmann (2018)
10.1148/radiol.2018181432
Automated Abdominal Segmentation of CT Scans for Body Composition Analysis Using Deep Learning.
A. Weston (2019)
10.1016/j.thorsurg.2013.04.001
Can we predict morbidity and mortality before an operation?
S. Ganai (2013)
10.1007/s00268-017-3999-2
Radiologically Determined Sarcopenia Predicts Morbidity and Mortality Following Abdominal Surgery: A Systematic Review and Meta-Analysis
K. Jones (2017)
10.1177/1457496917748221
Preoperative Computed Tomography–Determined Sarcopenia and Postoperative Outcome After Surgery for Non-Small Cell Lung Cancer
E. Kim (2018)
10.1016/j.jcct.2018.03.007
Computed tomography-based fat and muscle characteristics are associated with mortality after transcatheter aortic valve replacement.
B. Foldyna (2018)
10.1016/j.jamda.2011.01.003
Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia.
R. Fielding (2011)
10.1093/icvts/ivy280
Preoperative thoracic muscle area on computed tomography predicts long-term survival following pneumonectomy for lung cancer.
Fabian M. Troschel (2019)
10.1007/s10278-017-9988-z
Pixel-Level Deep Segmentation: Artificial Intelligence Quantifies Muscle on Computed Tomography for Body Morphometric Analysis
Hyunkwang Lee (2017)
10.1016/j.athoracsur.2010.05.014
Systematic classification of morbidity and mortality after thoracic surgery.
Andrew J. E. Seely (2010)
10.1245/s10434-017-6328-y
Clinical Impact and Risk Factors for Skeletal Muscle Loss After Complete Resection of Early Non-small Cell Lung Cancer
Shinkichi Takamori (2017)
10.1016/j.athoracsur.2016.06.077
Body Mass Index and Total Psoas Area Affect Outcomes in Patients Undergoing Pneumonectomy for Cancer.
R. Hervochon (2017)
10.1093/jjco/hyx009
Sarcopenia is a novel poor prognostic factor in male patients with pathological Stage I non-small cell lung cancer
T. Tsukioka (2017)
10.1016/j.surg.2014.04.027
Sarcopenia is a predictor of outcomes in very elderly patients undergoing emergency surgery.
Yang Du (2014)
10.1200/JCO.2018.78.6988
Need to Distinguish the Term Sarcopenia From Risk Stratification Derived From Muscle Parameters.
E. Parkin (2018)
10.1016/j.jamda.2017.03.019
Interventions for Treating Sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.
Y. Yoshimura (2017)
10.1007/s00423-014-1174-x
Core muscle size assessed by perioperative abdominal CT scan is related to mortality, postoperative complications, and hospitalization after major abdominal surgery: a systematic review
R. Hasselager (2014)
10.1016/j.jtcvs.2014.09.063
Pneumonectomy for lung cancer: contemporary national early morbidity and mortality outcomes.
P. Thomas (2015)
10.21037/jtd.2017.12.39
Sarcopenia is a predictor of outcomes after lobectomy.
J. A. Miller (2018)
10.1016/j.jvs.2010.10.111
Frailty, core muscle size, and mortality in patients undergoing open abdominal aortic aneurysm repair.
J. Lee (2011)
10.1016/j.jcrc.2017.10.033
Lumbar skeletal muscle index derived from routine computed tomography exams predict adverse post‐extubation outcomes in critically ill patients☆
G. Fuchs (2018)
10.1016/j.athoracsur.2010.05.041
Predictors of major morbidity and mortality after pneumonectomy utilizing the Society for Thoracic Surgeons General Thoracic Surgery Database.
M. Shapiro (2010)
10.1038/s41598-018-29825-5
Skeletal muscle cutoff values for sarcopenia diagnosis using T10 to L5 measurements in a healthy US population
B. Derstine (2018)
10.1016/j.jamcollsurg.2013.04.042
Cost of major surgery in the sarcopenic patient.
K. Sheetz (2013)
10.1093/ageing/afq034
Sarcopenia: European consensus on definition and diagnosis
A. Cruz-Jentoft (2010)
10.1016/j.athoracsur.2016.02.098
The Society of Thoracic Surgeons Lung Cancer Resection Risk Model: Higher Quality Data and Superior Outcomes.
F. Fernandez (2016)
10.1016/j.surge.2017.06.001
Sarcopaenia in surgical populations: A review.
Rachel S M Heard (2017)
10.1016/j.athoracsur.2018.02.010
Psoas Muscle Size Predicts Risk-Adjusted Outcomes After Surgical Aortic Valve Replacement.
Robert B Hawkins (2018)
10.1177/0884533615569888
Implications of sarcopenia in major surgery.
J. Friedman (2015)



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