title: Sarcopenia negatively affects preoperative total functional liver volume in patients undergoing liver resection.
abstract: OBJECTIVE
  Sarcopenia may negatively affect short-term outcomes after liver resection. The present study aimed to explore whether total functional liver volume (TFLV) is related to sarcopenia in patients undergoing partial liver resection.
  
  
  METHODS
  Analysis of total liver volume and tumour volume and measurements of muscle surface were performed in patients undergoing liver resection using OsiriX(®) and preoperative computed tomography. The ratio of TFLV to bodyweight was calculated as: [TFLV (ml)/bodyweight (g)]*100%. The L3 muscle index (cm(2) /m(2) ) was then calculated by normalizing muscle areas (at the third lumbar vertebral level) for height.
  
  
  RESULTS
  Of 40 patients, 27 (67.5%) were classified as sarcopenic. There was a significant correlation between the L3 skeletal muscle index and TFLV (r= 0.64, P < 0.001). Median TFLV was significantly lower in the sarcopenia group than in the non-sarcopenia group [1396 ml (range: 1129-2625 ml) and 1840 ml (range: 867-2404 ml), respectively; P < 0.05]. Median TFLV : bodyweight ratio was significantly lower in the sarcopenia group than in the non-sarcopenia group [2.0% (range: 1.4-2.5%) and 2.3% (range: 1.5-2.5%), respectively; P < 0.05].
  
  
  CONCLUSIONS
  Sarcopenic patients had a disproportionally small preoperative TFLV compared with non-sarcopenic patients undergoing liver resection. The preoperative hepatic physiologic reserve may therefore be smaller in sarcopenic patients.
authors.affiliation: Department of Surgery, Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands. s.dello@maastrichtuniversity.nl
authors.forename: Simon A W G
authors.initials: SA
authors.lastname: Dello
authors.forename: Toine M
authors.initials: TM
authors.lastname: Lodewick
authors.forename: Ronald M
authors.initials: RM
authors.lastname: van Dam
authors.forename: Kostan W
authors.initials: KW
authors.lastname: Reisinger
authors.forename: Maartje A J
authors.initials: MA
authors.lastname: van den Broek
authors.forename: Maarten F
authors.initials: MF
authors.lastname: von Meyenfeldt
authors.forename: Marc H A
authors.initials: MH
authors.lastname: Bemelmans
authors.forename: Steven W M
authors.initials: SW
authors.lastname: Olde Damink
authors.forename: Cornelis H C
authors.initials: CH
authors.lastname: Dejong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D001835:Body Weight; D016022:Case-Control Studies; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009929:Organ Size; D011237:Predictive Value of Tests; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden