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Author
Maeda, Naoaki Department of Gastroenterological Surgery, Graduate School of Medicine,Dentistry and Pharmaceutical Sciences
Shirakawa, Yasuhiro Department of Gastroenterological Surgery, Graduate School of Medicine,Dentistry and Pharmaceutical Sciences
Tanabe, Shunsuke Department of Gastroenterological Surgery, Graduate School of Medicine,Dentistry and Pharmaceutical Sciences Kaken ID
Sakurama, Kazufumi Department of Gastroenterological Surgery, Graduate School of Medicine,Dentistry and Pharmaceutical Sciences
Noma, Kazuhiro Department of Gastroenterological Surgery, Graduate School of Medicine,Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Fujiwara, Toshiyoshi Department of Gastroenterological Surgery, Graduate School of Medicine,Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Abstract
Background
The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery.
Methods
The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and February 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and 3 days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model.
Results
There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The 3-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group.
Conclusion
Skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis.
Published Date
2020-06-26
Publication Title
World Journal of Surgical Oncology
Volume
volume18
Issue
issue1
Publisher
BMC
Start Page
143
ISSN
1477-7819
NCID
AA12048269
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© The Author(s). 2020
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DOI
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Related Url
isVersionOf https://doi.org/10.1186/s12957-020-01908-6
License
http://creativecommons.org/licenses/by/4.0/