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Pediatric Surgery International Dec 2022This study aims to clarify the relationship between changes in skeletal muscle mass during treatment and prognosis of pediatric malignant solid tumors.
PURPOSE
This study aims to clarify the relationship between changes in skeletal muscle mass during treatment and prognosis of pediatric malignant solid tumors.
METHODS
Patients with pediatric malignant solid tumors who were treated at Kyushu University Hospital from 2007 to 2017 were divided into two groups: the progression-free survival (PFS) group and the relapse/death (R/D) group; the psoas major muscle volume (PMV) was then compared. We also measured the PMV and psoas muscle area (PMA) of pediatric patients with no complications who underwent surgery for acute appendicitis (control) and compared the values with those of patients with malignant tumors.
RESULTS
No significant differences were observed in the PMV and PMA between patients with appendicitis and those with malignant tumors. Significant differences were found in the rate of change in PMV between the PFS (1.424) and R/D groups (1.071) (P = 0.0024). When the cut-off value of the rate of change in the PMV was 1.20, patients whose rate of change in PMV was ≥ 1.20 had longer PFS (P = 0.0231) and overall survival (P = 0.0229) than those whose rate of change was < 1.20.
CONCLUSION
Pediatric patients with malignant solid tumors and increased skeletal muscle mass during treatment have a good prognosis.
Topics: Humans; Child; Sarcopenia; Appendicitis; Retrospective Studies; Prognosis; Psoas Muscles; Neoplasms
PubMed: 36169671
DOI: 10.1007/s00383-022-05225-9 -
Surgery Aug 2017Age-related loss of muscle mass and function (sarcopenia) is linked to poor outcomes after operation and trauma. Here we evaluate computed tomography measured psoas...
BACKGROUND
Age-related loss of muscle mass and function (sarcopenia) is linked to poor outcomes after operation and trauma. Here we evaluate computed tomography measured psoas muscle density and area using quick and simple tools available to the bedside clinician. We hypothesize these measures will predict poor outcomes after blunt traumatic injury.
METHODS
We conducted a retrospective cohort study of patients ages ≥45 years in the Ohio State University Trauma Registry in 2008 that received a computed tomographic scan of the abdomen and/or pelvis with intravenous contrast. Psoas Index and Hounsfield unit average calculation were measured at the L3 level. In the study, 90-day mortality, complication, duration of stay ≥7 days, and dependent discharge were compared with Psoas Index and Hounsfield unit average calculation.
RESULTS
In the study, 151 patients met the inclusion criteria. Patients were stratified into interquartile ranges based either on Psoas Index or Hounsfield unit average calculation values. After adjustment with sex-specific cutoffs, the lowest interquartile range of Psoas Index was associated with 90-day mortality (relative risk [RR] 5.95, P < .008), but did not reach significance in other outcomes. The lowest interquartile range of Hounsfield unit average calculation was associated with 90-day mortality (RR 5.95, P < .008), duration of stay ≥ 7 days (RR 1.63, P = .048), complication risk (RR 2.30, P = .002), and dependent discharge 2.14, P = .015).
CONCLUSION
Psoas muscle density is a significant predictor of poor outcomes after traumatic injury. This objective, quick, and readily available measure of sarcopenia can identify patients requiring aggressive nutritional and physical therapy to improve prognosis, prevent recurrent traumatic injury, and aid in discharge planning.
Topics: Aged; Female; Hospitalization; Humans; Male; Middle Aged; Predictive Value of Tests; Psoas Muscles; Retrospective Studies; Sarcopenia; Tomography, X-Ray Computed; Treatment Outcome; Wounds, Nonpenetrating
PubMed: 28551380
DOI: 10.1016/j.surg.2017.03.014 -
Asia-Pacific Journal of Clinical... Feb 2022The significance of sarcopenia in cancers has been widely recognized. However, few studies have focused on chronological changes in sarcopenia in cancer patients. This...
AIM
The significance of sarcopenia in cancers has been widely recognized. However, few studies have focused on chronological changes in sarcopenia in cancer patients. This study aimed to clarify the clinical significance of changes in the psoas muscle area before and after preoperative chemotherapy.
METHODS
This study included 39 patients who underwent gastrectomy followed by preoperative chemotherapy for advanced gastric cancer between January 2010 and December 2016 in our hospital. The psoas muscle area was measured at the umbilical level before and after chemotherapy, and the relationship between its chronological changes and the long-term prognosis was examined.
RESULTS
Patients were classified into two groups according to changes in the psoas muscle area before and after preoperative chemotherapy: remarkable muscle depletion and normal groups. No significant differences were observed in clinicopathological factors. Notably, the remarkable muscle depletion group included significantly more male patients (P = .018) and showed a high weight loss rate (P < .001). Although no significant difference was observed in the recurrence-free survival between the two groups (P = .484), overall survival was significantly worse in the remarkable muscle depletion group (P < .001). Multivariate analysis for prognosis revealed that pathological stage III or higher (P = .022) and decreased psoas muscle area (P = .038) were independent prognostic factors.
CONCLUSIONS
The present findings suggest that psoas muscle depletion during preoperative chemotherapy is a prognostic factor for poor long-term outcomes in patients who underwent gastrectomy followed by preoperative chemotherapy for advanced gastric cancer.
Topics: Gastrectomy; Humans; Male; Prognosis; Psoas Muscles; Retrospective Studies; Sarcopenia; Stomach Neoplasms
PubMed: 33644991
DOI: 10.1111/ajco.13514 -
Journal of Korean Medical Science May 2023Sarcopenia can be associated with the disease etiologies other than degenerative processes, such as neurologic disease including cerebral palsy, myelomeningocele, or...
BACKGROUND
Sarcopenia can be associated with the disease etiologies other than degenerative processes, such as neurologic disease including cerebral palsy, myelomeningocele, or Duchenne muscular dystrophy, even in children. Although the relationship between neurologic disease and scoliosis or ambulatory function is known, the mediators affecting scoliosis or gait function in these patients are unclear, an example might be sarcopenia. This study aimed to assess the degree of sarcopenia in young patients with neurologic diseases using computed tomography (CT), and analyze the correlation between sarcopenia and scoliosis or ambulatory function.
METHODS
Pediatric and young adult patients (≤ 25 years old) who underwent whole-spine or lower-extremity CT were retrospectively included. From bilateral psoas muscle areas (PMAs) at the L3 level, the psoas muscle z-score (PMz) and psoas muscle index [PMI = PMA/(L3 height)²] were calculated. The -test, Fisher's exact test, and logistic regression analyses were performed.
RESULTS
A total of 121 patients (56 men, mean age 12.2 ± 3.7 years) were included with 79 neurologic and 42 non-neurologic diseases. Patients with neurologic diseases had lower PMz ( = 0.013) and PMI ( = 0.026) than patients without. In neurologic disease patients, severe scoliosis patients showed lower PMz ( < 0.001) and PMI ( = 0.001). Non-ambulatory patients (n = 42) showed lower BMI (β = 0.727, < 0.001) and PMz (β = 0.547, = 0.025). In non-ambulatory patients, patients with severe scoliosis also showed lower PMz ( < 0.001) and PMI ( = 0.004).
CONCLUSION
Patients with neurologic diseases could have sarcopenia even in young age. Psoas muscle volume was also associated with ambulatory function in these patients. Sarcopenia was more severe in severe scoliosis patients in the non-ambulatory subgroup.
Topics: Male; Young Adult; Humans; Child; Adolescent; Adult; Sarcopenia; Retrospective Studies; Scoliosis; Neuromuscular Diseases; Muscles
PubMed: 37270922
DOI: 10.3346/jkms.2023.38.e187 -
In Vivo (Athens, Greece) 2023Accumulating evidence suggests that muscle mass depletion (sarcopenia) has a negative impact on survival in several malignancies, including biliary tract cancer (BTC)....
BACKGROUND/AIM
Accumulating evidence suggests that muscle mass depletion (sarcopenia) has a negative impact on survival in several malignancies, including biliary tract cancer (BTC). Computed tomography (CT)-measured psoas muscle thickness to height ratio (PMTH) has been reported as a surrogate measure for muscle mass that does not require specialized equipment or software. The aim of this retrospective study was to investigate whether preoperative PMTH predicts oncological outcomes of patients undergoing surgical resection for BTC.
PATIENTS AND METHODS
PMTH was assessed in 211 patients by analyzing axial CT images at the level of the umbilicus. The most predictive cutoff of PMTH was determined by survival classification and regression tree analysis. Propensity score-based inverse probability weighting (IPW) was used to balance characteristics between the low and high PMTH groups.
RESULTS
Applying a PMTH cutoff of 17.5 mm/m, the low PMTH group comprised 114 patients (54%). Low PMTH was associated with female sex, non-obesity, CA19-9 elevation, and lymph node metastasis. After IPW adjustment, the low PMTH group had a significantly shorter disease-specific survival (p<0.001) and relapse-free survival (p<0.001) than the high PMTH group. IPW-adjusted regression analysis revealed that a low PMTH was independently associated with worse disease-specific survival (hazard ratio=2.98, p<0.001) and relapse-free survival (hazard ratio=2.49, p<0.001), in addition to other factors such as tumor differentiation, perineural invasion, and resection margin status.
CONCLUSION
Preoperative PMTH may be a simple and feasible index of sarcopenia for predicting poor survival after resection of BTC.
Topics: Humans; Psoas Muscles; Retrospective Studies; Sarcopenia; Biliary Tract Neoplasms; CA-19-9 Antigen
PubMed: 36881051
DOI: 10.21873/invivo.13156 -
Journal of Diabetes and Its... Jun 2018Recent studies revealed a correlation between skeletal muscle mass index and density with longevity; these studies largely evaluated appendicular skeletal muscles in...
AIM
Recent studies revealed a correlation between skeletal muscle mass index and density with longevity; these studies largely evaluated appendicular skeletal muscles in older Caucasians. This retrospective cohort study assessed the association between axial skeletal muscles size and density with survival in African Americans with type 2 diabetes mellitus.
METHODS
Psoas and paraspinous muscle mass index (cross sectional area/height) and radiographic density (in Hounsfield Units) were measured using computed tomography in African American-Diabetes Heart Study participants, 314 women and 256 men, with median (25th, 75th quartile) age 55.0(48.0, 62.0) and 57.0(50.0, 64.0) years, respectively. Covariates in fully-adjusted model included age, sex, BMI, smoking, hormone replacement therapy (women), cardiovascular disease, hypertension, coronary artery calcified plaque mass, carotid artery calcified plaque mass, and African ancestry proportion.
RESULTS
After median of 7.1(5.9, 8.2) years follow-up, 30(9.6%) of women and 49(19.1%) of men were deceased. In fully-adjusted models, psoas muscle mass index and paraspinous muscle mass index were inversely associated with mortality in men (psoas muscle mass index, hazard ratio [HR] = 0.61, P = 0.004; paraspinous muscle mass index, HR = 0.64, P = 0.004), but not in women. Psoas and paraspinous muscle densities did not associate with all-cause mortality. A penalized Cox regression that involved all covariates and predictors associated with mortality showed that only paraspinous muscle mass index remained a significant predictor of mortality (HR = 0.65, P = 0.02).
CONCLUSION
Independent from established risk factors for mortality, higher psoas and paraspinous muscle index associate with reduced all-cause mortality in middle-aged African American men with type 2 diabetes mellitus.
Topics: Black or African American; Body Composition; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Health Status Indicators; Humans; Male; Middle Aged; Paraspinal Muscles; Prognosis; Psoas Muscles; Retrospective Studies; Survival Analysis; Tomography, X-Ray Computed
PubMed: 29627372
DOI: 10.1016/j.jdiacomp.2018.03.004 -
Scientific Reports Aug 2021We aimed to evaluate factors associated with changes in skeletal muscle mass in hepatitis C virus (HCV)-infected patients after treatment with direct-acting antivirals...
We aimed to evaluate factors associated with changes in skeletal muscle mass in hepatitis C virus (HCV)-infected patients after treatment with direct-acting antivirals (DAAs). Consecutive HCV-infected patients after treatment with DAA were recruited into the study. Patients who achieved sustained virological response (SVR); and had complete clinical information, preserved serum samples at baseline and SVR48, and skeletal muscle mass evaluations based on the psoas muscle mass index (PMI) on computed tomography at baseline and ≥ 12 months were included. Altogether, 70.7% of patients (41/58) showed increased PMI after DAA therapy, and mean relative PMI was significantly higher after DAA therapy than at baseline. There were no significant associations between baseline clinical factors routinely examined in clinical practice and increased PMI. Among factors reported to be associated with skeletal muscle loss in patients with chronic liver disease, serum zinc levels and total and free carnitine levels increased significantly after DAA therapy and only changes in serum free carnitine levels were significantly associated with an increased PMI (r = 0305, P = 0.020). In conclusion, increased skeletal muscle mass after successful HCV eradication by DAAs was significantly associated with increased serum-free carnitine levels. L-carnitine supplementation may be beneficial in patients with low skeletal muscle mass after DAA.
Topics: Adult; Aged; Aged, 80 and over; Amino Acids, Branched-Chain; Antiviral Agents; Carnitine; Female; Hepatitis C, Chronic; Humans; Insulin-Like Growth Factor I; Male; Middle Aged; Organ Size; Psoas Muscles; Sustained Virologic Response; Vitamin D; Zinc
PubMed: 34400736
DOI: 10.1038/s41598-021-96203-z -
JPEN. Journal of Parenteral and Enteral... Jan 2018Low muscle mass and quality are associated with poor surgical outcomes. We evaluated computed tomography (CT)-measured psoas muscle density as a marker of muscle quality...
BACKGROUND
Low muscle mass and quality are associated with poor surgical outcomes. We evaluated computed tomography (CT)-measured psoas muscle density as a marker of muscle quality and physiologic reserve and hypothesized that it predicts poor outcomes after enterocutaneous fistula repair (ECF).
METHODS
We conducted a retrospective cohort study of patients 18-90 years old with ECF who failed nonoperative management, requiring elective operative repair at The Ohio State University (2005-2016), and who received preoperative abdomen/pelvis CT scan with intravenous contrast within 3 months of the operation. Psoas Hounsfield unit average calculations were measured at the L3 level. One-year leak rate, mortality (90 days, 1 years, and 3 years), complication risk, length of stay, dependent discharge, and 30-day readmission were compared with Hounsfield unit average calculation (HUAC).
RESULTS
One hundred patients met inclusion criteria. Patients were stratified into interquartile ranges based on HUAC. The lowest HUAC interquartile was our low muscle quality (LMQ) cutoff, which was associated with 1-year leak (relative risk [RR] = 2.10, P < .005), 1-year mortality (RR = 2.22, P < .04) and 3-year mortality (RR = 2.13, P < .007), complication risk (RR = 1.54, P < .001), and dependent discharge (RR = 2.50, P < .004) compared to patients without LMQ.
CONCLUSIONS
Psoas muscle density is a significant predictor of poor outcomes in ECF repair. This readily available measure of physiologic reserve can identify patients with ECF who have increased risk and may benefit from additional interventions and recovery time before operative repair.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Humans; Intestinal Fistula; Length of Stay; Male; Middle Aged; Ohio; Postoperative Complications; Predictive Value of Tests; Psoas Muscles; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed; Young Adult
PubMed: 29505144
DOI: 10.1002/jpen.1028 -
Aging Clinical and Experimental Research Sep 2022Myosteatosis, skeletal muscle fat infiltration, is associated with inflammation and fibrosis. The age-related increase of myosteatosis is an important characteristic of...
BACKGROUND
Myosteatosis, skeletal muscle fat infiltration, is associated with inflammation and fibrosis. The age-related increase of myosteatosis is an important characteristic of sarcopenia and contributes to fragility.
AIMS
To investigate the impact of healthy aging on intermuscular adipose tissue (IMAT) and muscle fat fraction (FF) in the thigh and the paraspinal muscles in males.
METHODS
In 54 healthy males (age 20-70), all active hobby golfers, magnetic resonance imaging was performed to determine volume of IMAT, volume of muscle tissue (MT) and of percentage of FF.
RESULTS
Between ages 20-70, at the thigh, IMAT/MT volume and MT FF increased annually by 2.9% and 1.3%, respectively. At the psoas IMAT/Psoas volume did not change with age. MT FF increased by 1.5% annually. At the erector spinae IMAT/Erector volume decreased by 0.3% and MT FF increased by 2.8% annually.
DISCUSSION
With increasing age, in males, thigh muscle atrophied, muscle tissue was partly replaced by adipose tissue and remaining muscle tissue also contained more fat. Similar effects were observed in the erector spinae. The psoas muscle did not atrophy, although MT FF also increased with age. Overall correlations with age were weak to moderate with higher correlations observed in the paraspinal muscles.
CONCLUSIONS
Age-related increases of muscle fat infiltration were observed in the thigh and in the spine. Muscle atrophy did not occur in the psoas. In cross-sectional studies, an adjustment of volumetric parameters by muscle volume is advisable when comparing age-dependent results.
Topics: Adipose Tissue; Aged; Cross-Sectional Studies; Humans; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Muscular Atrophy; Paraspinal Muscles; Thigh
PubMed: 35633478
DOI: 10.1007/s40520-022-02149-1 -
Frontiers in Nutrition 2023We aimed to assess the prognostic implications of muscle atrophy and high subcutaneous adipose tissue (SAT) radiodensity in patients with hepatocellular carcinoma (HCC).
INTRODUCTION
We aimed to assess the prognostic implications of muscle atrophy and high subcutaneous adipose tissue (SAT) radiodensity in patients with hepatocellular carcinoma (HCC).
METHODS
In this retrospective study, muscle atrophy was assessed using the psoas muscle index (PMI) obtained from computed tomography. SAT radiodensity was evaluated based on radiodensity measurements. Survival and multivariate analyses were performed to identify factors associated with prognosis. The impact of muscle atrophy and high SAT radiodensity on prognosis was determined through survival analysis.
RESULTS
A total of 201 patients (median age: 71 years; 76.6% male) with HCC were included. Liver cirrhosis was observed in 72.6% of patients, and the predominant Child-Pugh grade was A (77.1%). A total of 33.3% of patients exhibited muscle atrophy based on PMI values, whereas 12.9% had high SAT radiodensity. Kaplan-Meier survival analysis demonstrated that patients with muscle atrophy had significantly poorer prognosis than those without muscle atrophy. Patients with high SAT radiodensity had a significantly worse prognosis than those without it. Muscle atrophy, high SAT radiodensity, the Barcelona Clinic Liver Cancer class B, C, or D, and Child-Pugh score ≥ 6 were significantly associated with overall survival. Further classification of patients into four groups based on the presence or absence of muscle atrophy and high SAT radiodensity revealed that patients with both muscle atrophy and high SAT radiodensity had the poorest prognosis.
CONCLUSION
Muscle atrophy and high SAT radiodensity are significantly associated with poor prognosis in patients with HCC. Identifying this high-risk subgroup may facilitate the implementation of targeted interventions, including nutritional therapy and exercise, to potentially improve clinical outcomes.
PubMed: 37867493
DOI: 10.3389/fnut.2023.1272728