title: Preoperative sarcopenia determinants in pancreatic cancer patients.
abstract: Recent studies report that muscle depletion can impair short and long-term results after abdominal surgery. The aim of the present study is to quantify sarcopenia rate in patients undergoing pancreatic resection for cancer and to identify possible determinants of muscle waste.
  
  
  
  Total abdominal muscle area (TAMA) and visceral fat area (VFA) were measured by preoperative CT scan imaging at the level of the third lumbar vertebra in 273 patients undergoing pancreas resection for cancer. Demographics, preoperative parameters, and cancer stage were prospectively collected in our Institutional electronic database. An adjusted regression model was used to identify independent predictors for low TAMA.
  
  
  
  176 (64.5%) patients were sarcopenic, with only 52 of them showing weight loss > 10%. Patients with cancer stage II and III had lower TAMA compared to patients with stage I (p = 0.002). The magnitude of weight loss was inversely correlated with VFA (p = 0.001), while no correlation with TAMA was found. Multivariate analysis showed that cancer stage was an independent predictor of low TAMA. Patients aged over 75 had the highest probability of having both low TAMA (p = 0.031) and high VFA (p < 0.0001).
  
  
  
  Most of patients undergoing oncologic pancreatic surgery are sarcopenic. Cancer stage was an independent determinant of sarcopenia while nutritional factors seem less important. An age of over 75 years was significantly correlated with both muscle compartment depletion and visceral fat increase.
authors: Department of Surgery, Vita-Salute San Raffaele University, Milan, Italy.
authors: Giulia
authors: G
authors: Carrara
authors: Department of Surgery, Vita-Salute San Raffaele University, Milan, Italy.
authors: Nicolò
authors: N
authors: Pecorelli
authors: Department of Radiology, Vita-Salute San Raffaele University, Milan, Italy.
authors: Francesco
authors: F
authors: De Cobelli
authors: Department of Radiology, Vita-Salute San Raffaele University, Milan, Italy.
authors: Giulia
authors: G
authors: Cristel
authors: Department of Radiology, Vita-Salute San Raffaele University, Milan, Italy.
authors: Anna
authors: A
authors: Damascelli
authors: Department of Anesthesiology, Vita-Salute San Raffaele University, Milan, Italy.
authors: Luigi
authors: L
authors: Beretta
authors: Department of Surgery, Vita-Salute San Raffaele University, Milan, Italy. Electronic address: braga.marco@hsr.it.
authors: Marco
authors: M
authors: Braga
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed
keywords: Elderly; Pancreatic cancer; Sarcopenia; Visceral fat