title: Sarcopenia as a prognostic factor in hepatolithiasis-associated intrahepatic cholangiocarcinoma patients following hepatectomy: a retrospective study.
abstract: BACKGROUND
  Sarcopenia is closely associated with poor performance status and high mortality in cancer patients. The present study is to determine the correlation between sarcopenia and prognosis of hepatectomy for hepatolithiasis-associated intrahepatic cholangiocarcinoma (IHHCC).
  
  
  METHODS
  Sixty-seven eligible IHHCC patients who underwent hepatectomy, between January 2000 and August 2014 were retrospectively evaluated. Sarcopenia was determined from skeletal muscle index (SMI), assessed by skeletal muscle mass on axial computed tomography images. Factors contributing to overall survival (OS) and recurrence-free survival (RFS) were analyzed by univariate and multivariate analyses.
  
  
  RESULTS
  Sarcopenia occurred in 33 (49.3%) out of 67 patients. Median OS of the enrolled patients was 12 months. Sarcopenic patients had a shorter OS compared with non-sarcopenic patients (P < 0.001). On univariate analyses, sarcopenia was significantly associated with overall survival (OS) and recurrence-free survival (RFS; both P < 0.05). On multivariate analysis, sarcopenic patients suffered poor overall survival (P < 0.001) and recurrence-free survival (P = 0.011) compared with non-sarcopenic patients.
  
  
  CONCLUSIONS
  Preoperative sarcopenia is an independent biomarker of poor prognosis in IHHCC patients following hepatectomy. The identification of sarcopenia may enhance a clinical consideration on decision making for IHHCC patients before surgery.
authors.affiliation: School of Medicine, Wenzhou Medical University Wenzhou, Zhejiang, China.
authors.forename: Gongting
authors.initials: G
authors.lastname: Zhou
authors.affiliation: School of Medicine, Wenzhou Medical University Wenzhou, Zhejiang, China.
authors.forename: Haili
authors.initials: H
authors.lastname: Bao
authors.affiliation: The First Affiliated Hospital of Wenzhou Medical University Wenzhou, Zhejiang, China.
authors.forename: Qiqiang
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: School of Medicine, Wenzhou Medical University Wenzhou, Zhejiang, China.
authors.forename: Weijian
authors.initials: W
authors.lastname: Hu
authors.affiliation: The First Affiliated Hospital of Wenzhou Medical University Wenzhou, Zhejiang, China.
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Zhang
keywords: Sarcopenia; hepatectomy; hepatolithiasis-associated intrahepatic cholangiocarcinoma (IHHCC); prognosis