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Nakanishi K, Ozeki N, Tateyama H, Kadomatsu Y, Ueno H, Goto M, Nakamura S, Fukumoto K, Chen-Yoshikawa TF. Skeletal muscle and related protein expression as prognostic factors in thymic squamous cell carcinoma. J Thorac Dis 2022; 14:3245-3254. [PMID: 36245599 PMCID: PMC9562531 DOI: 10.21037/jtd-22-385] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/01/2022] [Indexed: 01/18/2023]
Abstract
Background Sarcopenia and its marker, the psoas muscle index (PMI), have attracted attention as prognostic factors for various types of cancers. The fragile X-related 1 (FXR1) gene is highly expressed in myocytes, and FXR1 overexpression is a candidate biomarker for poor survival in several types of cancers. Thymic squamous cell carcinoma (TSQCC) is rare, and no studies assessing its prognostic factors, particularly in terms of skeletal muscle mass and FXR1 expression, are available. Methods We retrospectively investigated the prognostic significance of PMI in 34 patients who underwent TSQCC resection, considering the status of FXR1 and tumor programmed death-ligand 1 (PD-L1). PMI was calculated from the bilateral psoas muscle using preoperative computed tomography (CT). Patients were divided into two groups: low PMI (<58.2%, n=17) and normal PMI (≥58.2%, n=17). Immunohistochemical analysis was performed to determine the FXR1 and PD-L1 expression levels. Results Low PMI was significantly associated with worse overall survival (OS) (5-year survival rate; 86% vs. 100%; P=0.026) and marginally associated with worse disease-free survival (DFS) (5-year survival rate; 39% vs. 66%; P=0.090) compared with normal PMI. The immunohistochemical analysis revealed that the FXR1 intensity score (0-1+: 6% vs. 0%; 2+-3+: 94% vs. 100%; P=0.31), median FXR1 distribution (95% vs. 90%; P=0.63), and PD-L1 status (high: 47% vs. 59%; P=0.49) were not significantly different between the two groups. Conclusions Our findings suggest that PMI might be considered as a potential prognostic factor in TSQCC and that FXR1 is widely expressed regardless of the PMI status. Skeletal muscle mass may play a role in the prognosis of TSQCC.
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Affiliation(s)
- Keita Nakanishi
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Ozeki
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisashi Tateyama
- Department of Pathology, Clinical Laboratory, Kasugai Municipal Hospital, Kasugai, Japan
| | - Yuka Kadomatsu
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Harushi Ueno
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaki Goto
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shota Nakamura
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koichi Fukumoto
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tan Y, Duan T, Li B, Zhang B, Zhu Y, Yan K, Song J, Lv T, Yang J, Jiang L, Yang J, Wen T, Yan L. Sarcopenia defined by psoas muscle index independently predicts long-term survival after living donor liver transplantation in male recipients. Quant Imaging Med Surg 2022; 12:215-228. [PMID: 34993073 DOI: 10.21037/qims-21-314] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/25/2021] [Indexed: 02/05/2023]
Abstract
Background The effect of sarcopenia on long-term outcomes in recipients after living donor liver transplantation (LDLT), including overall survival and hepatocellular carcinoma (HCC) recurrence, remains unclear, especially in China. Methods From 2009 to 2015, 117 adult patients underwent LDLT in our center. In all, 82 patients who had computed tomography images reaching the third lumbar vertebra level within 1 month of LDLT were included; 70 male patients were included in the final analysis after excluding 12 female patients because of poor performance of the calculated cutoff value. Sarcopenia was defined according to the psoas muscle index (PMI) cutoff value, which was calculated based on dynamic time-dependent outcomes using X-tile software. Cox proportional hazards models were used to assess multivariate-adjusted hazards ratios (HRs) to seek potential correlations between sarcopenia and posttransplant outcomes. Results According to the cutoff value of PMI (6.25 cm2/m2), 38 patients (54.3%) were diagnosed with sarcopenia. After an average of 63.3 months of follow-up, 21 patients died after LDLT, 16 in the sarcopenia group and 5 in the non-sarcopenia group, respectively. Sarcopenia was identified as being significantly associated with worse posttransplant overall survival in multivariate analysis, resulting in an HR of 3.22 [95% confidence interval (CI), 1.15-8.98]. Among the 50 recipients with HCC, sarcopenia was significantly associated with HCC recurrence in univariate analysis (HR 2.87, 95% CI, 1.06-7.80) but was not detected as an independent risk factor of HCC recurrence in multivariate analysis, although a trend (tendency)towards significance was observed (HR 2.60, 95% CI, 0.95-7.10; P=0.062). Conclusions Sarcopenia defined by PMI is a feasible and reliable independent predictor of posttransplant overall survival in male LDLT candidates. However, its correlation with posttransplant HCC recurrence remains uncertain.
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Affiliation(s)
- Yifei Tan
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Ting Duan
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Li
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Bohan Zhang
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Yunfeng Zhu
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Ke Yan
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Jiulin Song
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Lv
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Jian Yang
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Li Jiang
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Jiayin Yang
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Tianfu Wen
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Lunan Yan
- Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
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Fang Z, Du F, Shang L, Liu J, Ren F, Liu Y, Wu H, Liu Y, Li P, Li L. CT assessment of preoperative nutritional status in gastric cancer: severe low skeletal muscle mass and obesity-related low skeletal muscle mass are unfavorable factors of postoperative complications. Expert Rev Gastroenterol Hepatol 2021; 15:317-324. [PMID: 33063547 DOI: 10.1080/17474124.2021.1836959] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Computed tomography (CT) has become an important technique for assessing skeletal muscle mass. Low skeletal muscle mass (LSMM) is considered an unfavorable factor for postoperative complications in patients with gastric cancer (GC). METHODS Patients who underwent laparoscopic gastrectomy for GC were included. Skeletal muscle mass at the third lumbar vertebra (L3) level was measured by preoperatively using CT. The patients were divided into an LSMM group and a non-LSMM group and the intergroup differences were analyzed. Furthermore, we divided the LSMM group into mild and severe LSMM subgroups. The study also analyzed the influence of obesity-related LSMM on postoperative complications. RESULTS A total of 409 patients were enrolled; of them, 265 had LSMM and 41 had severe LSMM. LSMM was associated with age, body mass index, and Nutritional Risk Screening 2002 score. In the multivariate analysis, LSMM was not related to postoperative complications. Further analysis revealed that severe LSMM was a risk factor for postoperative complications. The study also found that the risk of postoperative complications was significantly increased in patients with obesity-related LSMM. CONCLUSIONS LSMM was not significantly correlated with postoperative complications. Severe LSMM and obesity-related LSMM are unfavorable factors for postoperative complications with GC after gastrectomy.
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Affiliation(s)
- Zhen Fang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China
| | - Fengying Du
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China
| | - Liang Shang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China.,Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University , Jinan, Shandong, China.,Key Laboratory of Engineering of Shandong Province, Shandong Provincial Hospital , Jinan, Shandong, China
| | - Jin Liu
- Key Laboratory of Engineering of Shandong Province, Shandong Provincial Hospital , Jinan, Shandong, China.,Department of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China.,Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University , Jinan, Shandong, China
| | - Fuxin Ren
- Shandong Medical Imaging Research Institute , Jinan, China
| | - Yubo Liu
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University , Jinan, China
| | - Hao Wu
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China
| | - Yang Liu
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China
| | - Peijuan Li
- General Medicine, Beijing Friendship Hospital Affiliated to Capital Medical University , Beijing, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University , Jinan, Shandong, China.,Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University , Jinan, Shandong, China.,Key Laboratory of Engineering of Shandong Province, Shandong Provincial Hospital , Jinan, Shandong, China
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Hammad A, Kaido T, Hamaguchi Y, Okumura S, Kobayashi A, Shirai H, Kamo N, Yagi S, Uemoto S. Impact of sarcopenic overweight on the outcomes after living donor liver transplantation. Hepatobiliary Surg Nutr 2017; 6:367-378. [PMID: 29312971 DOI: 10.21037/hbsn.2017.02.02] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background The effect of body composition disturbances has been recently in focus. Sarcopenic obesity, a co-occurrence of low muscle mass and high body fat was reportedly predictive of high mortality in patients with cirrhosis. However, the impact of the interacting sarcopenia and overweight on the outcomes after liver transplantation is still unclear. Methods We evaluated 200 patients undergoing adult-to-adult living donor liver transplantation at our institution between January 2008 and November 2013 classified according to BMI and psoas muscle index (PMI) on admission to transplant into 4 subgroups; sarcopenic overweight (SO), sarcopenic non-overweight (SN), non-sarcopenic overweight and non-sarcopenic non-overweight (NN). Short-term outcomes and overall post-transplant survival were compared among the four subgroups. Results Sarcopenic patients with preoperative low PMI had higher incidence of postoperative bacteremia and major postoperative complications, and poorer overall post-transplant survival than non-sarcopenic patients with normal/high PMI (P<0.001, respectively). Overweight recipients had a significantly higher overall survival (OS) rate than non-overweight patients (P=0.021). SO subgroup (low PMI and BMI ≥25) had statistically indifferent incidence of postoperative bacteremia, major postoperative complications or overall post-transplant survival than other recipients. In contrast, SN subgroup (low PMI and BMI <25) had higher incidence of postoperative bacteremia (P<0.001), major postoperative complications (P<0.001) than the SO subgroup and possessed the poorest OS among the four recipient subgroups (P=0.001). Conclusions In living donor liver transplantation, preoperative SO did not confer added significant morbidity or mortality risks than the stand-alone sarcopenia.
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Affiliation(s)
- Ahmed Hammad
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Surgery, Mansoura University, Mansoura, Egypt
| | - Toshimi Kaido
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuhei Hamaguchi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinya Okumura
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Kobayashi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisaya Shirai
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoko Kamo
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shintaro Yagi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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