Effect of Sarcopenia on Postoperative Complications after Curative Pancreatectomy for Adenocarcinoma

Abstract

Objective: This study aimed to investigate the effect of sarcopenia on the development of serious postoperative complications in patients who underwent curative pancreatectomy for pancreatic cancer.
 Methods: Total psoas index (TPI) was calculated for sarcopenia diagnosis by measures of psoas muscle area on the level of L3 spine from preoperative staging computerised tomograhpy (CT) images in pancreatic cancer patients undergoing curative resection. Patient demographics and postoperative outcomes were analised in sarcopenic and non-sarcopenic group.
 Results: It has been found to be statistically significant relation between severe postoperative complication and sarcopenia (p=0,001>). Sarcopenia was more associated with cardiac and pulmoner complications among others (p=0.007, p=0.003 respectively). In multivariate analysis, age (OR: 1,08. %95 CI: 1,01~1,15, p=0,013), ASA score (OR: 2,84. 95% CI 1,62 ~ 4,97. p= 0,043) and TPI (OR: 3,61. 95% CI: 1,58 ~ 5,74. p= 0,001>) has been found independent risk factors for severe postoperative complications. 
 Conclusion: Our results suggest that sarcopenia determined by using TPI, which can be easily obtained by examining the preoperative CT imaging, is an independent risk factor of severe postoperative complications. Determining the degree of sarcopenia can affect patient selection, predictability of possible serious complications, elective operation preparation process with a combination of nutrition and exercise therapy in a particular patient group and decisions regarding adjuvant or neoadjuvant therapy.