Impact of Altered Body Composition on Clinical and Oncological Outcomes in Intrahepatic Cholangiocarcinoma
-
Published:2023-12-18
Issue:24
Volume:12
Page:7747
-
ISSN:2077-0383
-
Container-title:Journal of Clinical Medicine
-
language:en
-
Short-container-title:JCM
Author:
Wang Guanwu1, Otto Carlos C.12, Heij Lara R.12ORCID, Al-Masri Tarick M.13, Dahl Edgar4ORCID, Heise Daniel12, Olde Damink Steven W. M.5, Luedde Tom6ORCID, Lang Sven A.12, Ulmer Tom F.1, Neumann Ulf P.125, Bednarsch Jan12ORCID
Affiliation:
1. Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany 2. Department of Surgery and Transplantation, University Hospital Essen, 45147 Essen, Germany 3. University of Applied Science Aachen, 52066 Aachen, Germany 4. Institute of Pathology, University Hospital RWTH Aachen, 52074 Aachen, Germany 5. Department of Surgery, Maastricht University Medical Centre (MUMC), 6229 HX Maastricht, The Netherlands 6. Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
Abstract
Intrahepatic cholangiocarcinoma is a common primary liver tumor with limited treatment options and poor prognosis. Changes in body composition (BC) have been shown to affect the prognosis of various types of tumors. Therefore, our study aimed to investigate the correlation between BC and clinical and oncological outcomes in patients with iCCA. All patients with iCCA who had surgery from 2010 to 2022 at our institution were included. We used CT scans and 3D Slicer software to assess BC and conducted logistic regressions as well as Cox regressions and Kaplan–Meier analyses to investigate associations between BC and clinical variables with focus on postoperative complications and oncological outcomes. BC was frequently altered in iCCA (n = 162), with 53.1% of the patients showing obesity, 63.2% sarcopenia, 52.8% myosteatosis, 10.1% visceral obesity, and 15.3% sarcopenic obesity. The multivariate analysis showed no meaningful association between BC and perioperative complications. Myosteatosis was associated with reduced overall survival (OS) in iCCA patients (myosteatosis vs. non-myosteatosis, 7 vs. 18 months, p = 0.016 log rank). Further, the subgroup analysis revealed a notable effect in the subset of R0-resected patients (myosteatosis vs. non-myosteatosis, 18 vs. 32 months, p = 0.025) and patients with nodal metastases (myosteatosis vs. non-myosteatosis, 7 vs. 18 months, p = 0.016). While altered BC is not associated with perioperative outcomes in iCCA, myosteatosis emerges as a prognostic factor for reduced OS in the overall and sub-populations of resected patients.
Funder
China Scholarship Council
Reference45 articles.
1. Cancer statistics, 2022;Siegel;CA Cancer J. Clin.,2022 2. Intrahepatic cholangiocarcinoma: Rising frequency, improved survival, and determinants of outcome after resection;Endo;Ann. Surg.,2008 3. Bednarsch, J., Czigany, Z., Heij, L.R., Liu, D., Dulk, M.D., Wiltberger, G., Bruners, P., Ulmer, T.F., Neumann, U.P., and Lang, S.A. (2021). Compelling Long-Term Results for Liver Resection in Early Cholangiocarcinoma. J. Clin. Med., 10. 4. Yao, K.J., Jabbour, S., Parekh, N., Lin, Y., and Moss, R.A. (2016). Increasing mortality in the United States from cholangiocarcinoma: An analysis of the National Center for Health Statistics Database. BMC Gastroenterol., 16. 5. Evaluation and management of body composition changes in cancer patients;Wang;Nutrition,2023
|
|