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Sarcopenia is associated with increased mortality but not complications following resection and reconstruction of sarcoma of the extremities.

肌肉减少症与四肢肉瘤切除重建后死亡率增加有关,但与并发症无关。

  • 影响因子:2.88
  • DOI:10.1002/jso.25898
  • 作者列表:"Hendrickson NR","Mayo Z","Shamrock A","Kesler K","Glass N","Nau P","Miller BJ
  • 发表时间:2020-06-01
Abstract

BACKGROUND AND OBJECTIVES:Evidence regarding the impact of sarcopenia on operative outcomes in patients with sarcoma is lacking. We evaluated the relationship between sarcopenia and postoperative complications or mortality among patients undergoing tumor excision and reconstruction. ​ METHODS: We retrospectively reviewed 145 patients treated with tumor excision and limb reconstruction for sarcoma of the extremities. Sarcopenia was defined as psoas index (PI) < 5.45 cm2 /m2 for men and <3.85 cm2 /m2 for women from preoperative axial CT. Regression analyses were used to assess the association between postoperative complications or mortality with PI, age, gender, race, body mass index, tumor histology, grade, depth, location, size, and neoadjuvant/adjuvant therapy. RESULTS:There were 101 soft tissue tumors and 44 primary bone tumors. Sarcopenia was present in 38 patients (26%). Sarcopenic patients were older (median age: 72 vs 59 years, P = .0010) and had larger tumors (86.5%, >5 cm vs 77.7%, P = .023). Seventy-three patients experienced complications (51%) and 18 patients died within 1 year. Sarcopenia and metastatic disease were associated with increased 12-month mortality (hazard ratio [HR] = 6.68, P < .001; HR: 8.51, P < .001, respectively) but not complications (HR 1.45, P = .155, odds ratio, 1.32, P = .426, respectively). CONCLUSIONS:Sarcopenia and metastatic disease were independently associated with postoperative mortality but no complications following surgery.

摘要

背景和目的: 缺乏关于肌少症对肉瘤患者手术结果影响的证据。我们在接受肿瘤切除和重建的患者中评估了肌少症与术后并发症或死亡率之间的关系。方法: 我们回顾性分析了 145 例四肢肉瘤行肿瘤切除和肢体重建的患者。肌少症定义为术前轴位CT显示腰肌指数 (PI) 男性 <5.45 cm2 /m2,女性 <3.85 cm2 /m2。使用回归分析评估术后并发症或死亡率与PI、年龄、性别、种族、体重指数、肿瘤组织学、分级、深度、位置、大小、和新辅助/辅助治疗。 结果: 软组织肿瘤 101 例,原发性骨肿瘤 44 例。38 例患者 (26%) 存在肌少症。肌肉减少患者年龄较大 (中位年龄: 72 岁vs 59 岁,p =.0010),肿瘤较大 (86.5%,> 5厘米vs 77.7%,p =.023)。73 例患者出现并发症 (51%),18 例患者在 1 年内死亡。肌少症和转移性疾病与 12 个月死亡率增加相关 (风险比 [HR] = 6.68,p < 。001; HR: 8.51,p < 。001),但无并发症 (HR 1.45,p =  。155,比值比为 1.32,p =  。426,分别)。 结论: 肌少症和转移性疾病与术后死亡率独立相关,但术后无并发症。

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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