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Eur J Surg Oncol. 2018 Nov;44(11):1818-1823. doi: 10.1016/j.ejso.2018.07.060. Epub 2018 Aug 11.

Overall survival of pseudomyxoma peritonei and peritoneal mesothelioma patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy can be predicted by computed tomography quantified sarcopenia.

Author information

1
Department of Radiology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France; Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100, Villeurbanne, France.
2
Department of Radiology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France; Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100, Villeurbanne, France; EMR 3738, 165 Chemin du Petit Revoyet, 69921, Oullins, France. Electronic address: pascal.rousset@chu-lyon.fr.
3
Department of Oncologic and General Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France.
4
Department of Radiology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France; Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100, Villeurbanne, France; EMR 3738, 165 Chemin du Petit Revoyet, 69921, Oullins, France.
5
Lyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100, Villeurbanne, France; EMR 3738, 165 Chemin du Petit Revoyet, 69921, Oullins, France; Department of Oncologic and General Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite, France.

Abstract

BACKGROUND:

Malnutrition is associated with increased postoperative morbidity in abdominal surgery. This study aimed to determine if sarcopenia and/or abdominal fat composition could predict postoperative outcomes for patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for pseudomyxoma peritonei (PMP) and peritoneal mesothelioma (PM).

METHODS:

All patients who underwent a complete CRS-HIPEC for PMP and PM, between January 2009 and September 2017, were retrospectively studied. Preoperative computed tomography (CT) was used to measure the cross-sectional surface of skeletal muscle mass and adipose tissue (visceral and subcutaneous), at the level of the third lumbar vertebrae, to assess for sarcopenia and abdominal fat composition.

RESULTS:

Among 115 patients, 82 were treated for PMP and 33 for PM. 64 patients (55.7%) were sarcopenic on the preoperative imagery. Major postoperative complications occurred in 63 patients (54.8%), without observable difference between sarcopenic and non-sarcopenic patients (56.2% vs. 52.9%; p = 0.723). The median overall survival (OS) was 73.3 for the patients with a normal muscle mass and 57.2 months for the sarcopenic patients (p = 0.05).

CONCLUSION:

CT measured sarcopenia is an independent predictive factor for overall survival in patients treated for PMP and PM with CRS-HIPEC, but cannot predict postoperative morbidity.

KEYWORDS:

Mesothelioma; Peritoneal metastases; Pseudomyxoma peritonei; Skeletal muscle mass

PMID:
30143249
DOI:
10.1016/j.ejso.2018.07.060
[Indexed for MEDLINE]

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