Impact of sarcopenia on outcomes of patients undergoing pancreatectomy A retrospective analysis of 107 patients

To evaluate the prevalence of sarcopenia in patients undergoing pancreatic surgery and to examine its impact on the surgical outcomes and survival of patients. Skeletal muscle index (SMI) was measured on preoperative CT. A patient was considered sarcopenic if SMI was <38.5 cm(2)/m(2) for a female or <52.4 cm(2)/m(2) for a male. Postoperative pancreatic fistula (POPF) and severe morbidity (Clavien >= 3) were analyzed. Survival of patients with cancer was calculated using the Kaplan-Meier method. In total, 107 consecutive patients were included. Among them, 50 (47%) patients were sarcopenic and 65 (60%) were undernourished. The rates of severe morbidity and mortality were comparable between sarcopenic and nonsarcopenic groups. However, all POPF grade B or C and deaths occurred in the sarcopenic or nonsarcopenic overweight group (BMI> 25) with significantly lengthened hospital stays (P=.003). After pancreatectomy for cancer, 31 (40.2%) patients showed postoperative recurrence and 23 (29.9%) died after a median follow-up of 15 +/- 13.5 months. Despite comparable histological types and stages, the median overall and disease-free survivals were lower in sarcopenic patients (16 months vs not reached, P=.02 and 11.1 months vs 22.5 months; P=.04, respectively). The multivariate analysis revealed that, sarcopenia trended to increase the risk of death (HR=2.04, P=.07). Sarcopenia negatively impacted short-and long-term outcomes in patients undergoing pancreatectomy.