Sarcopenia and Skeletal Muscle Quality as Predictors of Postoperative Complication and Early Mortality in Gynecologic Cancer

This study aimed to evaluate the influence of sarcopenia and the indicators of skeletal muscle (SM) quality on surgical outcomes in women with ovarian and endometrial cancer who underwent oncologic surgery. Methods Endometrial and ovarian cancer patients admitted between 2008 and 2015 and who had computerized tomography images available within 45 days before surgery were enrolled in a retrospective cohort (n = 250). Computerized tomography images at the third lumbar vertebra were used to assess SM. Skeletal muscle index (SMI) was calculated in the range from −29 to +150 Hounsfield Units; reduced muscle attenuation (range, −29 to +29 HU) was classified as low-radiodensity skeletal muscle index (LRSMI). By subtracting the LRSMI area from total SMI, high-radiodensity skeletal muscle index (HRSMI) was created. Sarcopenia was defined when SMI was less than 38.9 cm2/m2. Multiple logistic regression evaluated predictors of surgical complications. Results Patients in lower HRSMI quartiles and in the highest quartiles of LRSMI had more postoperative surgical complication and had prolonged hospital stay. Both sarcopenia and the quality indicators of SM were predictors of increased risk of surgical complication, HRSMI being the strongest predictor. However, in a combined adjustment with sarcopenia, only HRSMI remained in the model as an independent predictor for surgical complication. In addition, HRSMI was the only indicator associated with early mortality (
Source: International Journal of Gynecological Cancer - Category: Cancer & Oncology Tags: Quality of Life Source Type: research