A high visceral adipose tissue-to-skeletal muscle ratio as a determinant of major complications after pancreatoduodenectomy for cancer

Marta Sandini, Davide P Bernasconi, Davide Fior, Matilde Molinelli, Davide Ippolito, Luca Nespoli, Riccardo Caccialanza, Luca Gianotti

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Complication rates after pancreatic resections remain high despite improvement in perioperative management. The effects of body composition and the relationship among different body compartments on surgical morbidity are not comprehensively investigated. The aim of this study was to assess whether the evaluation of different body compartments and their relationship was associated with the development of major postoperative complications after pancreatoduodenectomy (PD) for cancer.

METHODS: We retrospectively analyzed 124 patients who underwent PD and had a staging computed tomography (CT) scan at our center. CT scan was used to measure abdominal skeletal muscle area and volume, as well as visceral fat area (VFA) and volume. The total abdominal muscle area (TAMA) was then normalized for height. The severity of complications was assessed. Univariate and multivariate analyses were performed to investigate correlations between the above variables and postoperative complications. The receiver operating characteristic curve methodology was used to investigate the predictive ability of each parameter.

RESULTS: Major complications occurred in 42 patients (33.9%). The prevalence of sarcopenia was 24.2%. Regression analyses revealed no correlation between abdominal muscular and adipose tissue areas. Univariate analysis showed that the depletion of muscle area normalized for height was not per se predictive of complications (P = 0.318). Multivariate logistic regression showed that the VFA/TAMA was the only determinant of major complications (odds ratio, 3.20; 95% confidence interval, 1.35-7.60; P = 0.008). The model predictive performance was 0.735 (area under the curve) with a sensitivity of 64.3% and a specificity of 74.4%.

CONCLUSION: Sarcopenic obesity is a strong predictor of major complications after PD for cancer.

Original languageEnglish
Pages (from-to)1231-7
Number of pages7
JournalNutrition
Volume32
Issue number11-12
DOIs
Publication statusPublished - Jun 5 2016

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Abdominal Muscles
Pancreaticoduodenectomy
Intra-Abdominal Fat
Skeletal Muscle
Tomography
Sarcopenia
Neoplasms
Abdominal Fat
Body Composition
ROC Curve
Area Under Curve
Multivariate Analysis
Obesity
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Morbidity
Muscles

Keywords

  • Aged
  • Body Composition
  • Body Mass Index
  • Female
  • Humans
  • Intra-Abdominal Fat
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Muscle, Skeletal
  • Pancreatic Neoplasms
  • Pancreaticoduodenectomy
  • Postoperative Complications
  • Retrospective Studies
  • Risk Factors
  • Sarcopenia
  • Journal Article

Cite this

Sandini, M., Bernasconi, D. P., Fior, D., Molinelli, M., Ippolito, D., Nespoli, L., ... Gianotti, L. (2016). A high visceral adipose tissue-to-skeletal muscle ratio as a determinant of major complications after pancreatoduodenectomy for cancer. Nutrition, 32(11-12), 1231-7. https://doi.org/10.1016/j.nut.2016.04.002

A high visceral adipose tissue-to-skeletal muscle ratio as a determinant of major complications after pancreatoduodenectomy for cancer. / Sandini, Marta; Bernasconi, Davide P; Fior, Davide; Molinelli, Matilde; Ippolito, Davide; Nespoli, Luca; Caccialanza, Riccardo; Gianotti, Luca.

In: Nutrition, Vol. 32, No. 11-12, 05.06.2016, p. 1231-7.

Research output: Contribution to journalArticle

Sandini, Marta ; Bernasconi, Davide P ; Fior, Davide ; Molinelli, Matilde ; Ippolito, Davide ; Nespoli, Luca ; Caccialanza, Riccardo ; Gianotti, Luca. / A high visceral adipose tissue-to-skeletal muscle ratio as a determinant of major complications after pancreatoduodenectomy for cancer. In: Nutrition. 2016 ; Vol. 32, No. 11-12. pp. 1231-7.
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abstract = "OBJECTIVE: Complication rates after pancreatic resections remain high despite improvement in perioperative management. The effects of body composition and the relationship among different body compartments on surgical morbidity are not comprehensively investigated. The aim of this study was to assess whether the evaluation of different body compartments and their relationship was associated with the development of major postoperative complications after pancreatoduodenectomy (PD) for cancer.METHODS: We retrospectively analyzed 124 patients who underwent PD and had a staging computed tomography (CT) scan at our center. CT scan was used to measure abdominal skeletal muscle area and volume, as well as visceral fat area (VFA) and volume. The total abdominal muscle area (TAMA) was then normalized for height. The severity of complications was assessed. Univariate and multivariate analyses were performed to investigate correlations between the above variables and postoperative complications. The receiver operating characteristic curve methodology was used to investigate the predictive ability of each parameter.RESULTS: Major complications occurred in 42 patients (33.9{\%}). The prevalence of sarcopenia was 24.2{\%}. Regression analyses revealed no correlation between abdominal muscular and adipose tissue areas. Univariate analysis showed that the depletion of muscle area normalized for height was not per se predictive of complications (P = 0.318). Multivariate logistic regression showed that the VFA/TAMA was the only determinant of major complications (odds ratio, 3.20; 95{\%} confidence interval, 1.35-7.60; P = 0.008). The model predictive performance was 0.735 (area under the curve) with a sensitivity of 64.3{\%} and a specificity of 74.4{\%}.CONCLUSION: Sarcopenic obesity is a strong predictor of major complications after PD for cancer.",
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T1 - A high visceral adipose tissue-to-skeletal muscle ratio as a determinant of major complications after pancreatoduodenectomy for cancer

AU - Sandini, Marta

AU - Bernasconi, Davide P

AU - Fior, Davide

AU - Molinelli, Matilde

AU - Ippolito, Davide

AU - Nespoli, Luca

AU - Caccialanza, Riccardo

AU - Gianotti, Luca

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2016/6/5

Y1 - 2016/6/5

N2 - OBJECTIVE: Complication rates after pancreatic resections remain high despite improvement in perioperative management. The effects of body composition and the relationship among different body compartments on surgical morbidity are not comprehensively investigated. The aim of this study was to assess whether the evaluation of different body compartments and their relationship was associated with the development of major postoperative complications after pancreatoduodenectomy (PD) for cancer.METHODS: We retrospectively analyzed 124 patients who underwent PD and had a staging computed tomography (CT) scan at our center. CT scan was used to measure abdominal skeletal muscle area and volume, as well as visceral fat area (VFA) and volume. The total abdominal muscle area (TAMA) was then normalized for height. The severity of complications was assessed. Univariate and multivariate analyses were performed to investigate correlations between the above variables and postoperative complications. The receiver operating characteristic curve methodology was used to investigate the predictive ability of each parameter.RESULTS: Major complications occurred in 42 patients (33.9%). The prevalence of sarcopenia was 24.2%. Regression analyses revealed no correlation between abdominal muscular and adipose tissue areas. Univariate analysis showed that the depletion of muscle area normalized for height was not per se predictive of complications (P = 0.318). Multivariate logistic regression showed that the VFA/TAMA was the only determinant of major complications (odds ratio, 3.20; 95% confidence interval, 1.35-7.60; P = 0.008). The model predictive performance was 0.735 (area under the curve) with a sensitivity of 64.3% and a specificity of 74.4%.CONCLUSION: Sarcopenic obesity is a strong predictor of major complications after PD for cancer.

AB - OBJECTIVE: Complication rates after pancreatic resections remain high despite improvement in perioperative management. The effects of body composition and the relationship among different body compartments on surgical morbidity are not comprehensively investigated. The aim of this study was to assess whether the evaluation of different body compartments and their relationship was associated with the development of major postoperative complications after pancreatoduodenectomy (PD) for cancer.METHODS: We retrospectively analyzed 124 patients who underwent PD and had a staging computed tomography (CT) scan at our center. CT scan was used to measure abdominal skeletal muscle area and volume, as well as visceral fat area (VFA) and volume. The total abdominal muscle area (TAMA) was then normalized for height. The severity of complications was assessed. Univariate and multivariate analyses were performed to investigate correlations between the above variables and postoperative complications. The receiver operating characteristic curve methodology was used to investigate the predictive ability of each parameter.RESULTS: Major complications occurred in 42 patients (33.9%). The prevalence of sarcopenia was 24.2%. Regression analyses revealed no correlation between abdominal muscular and adipose tissue areas. Univariate analysis showed that the depletion of muscle area normalized for height was not per se predictive of complications (P = 0.318). Multivariate logistic regression showed that the VFA/TAMA was the only determinant of major complications (odds ratio, 3.20; 95% confidence interval, 1.35-7.60; P = 0.008). The model predictive performance was 0.735 (area under the curve) with a sensitivity of 64.3% and a specificity of 74.4%.CONCLUSION: Sarcopenic obesity is a strong predictor of major complications after PD for cancer.

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KW - Intra-Abdominal Fat

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KW - Multidetector Computed Tomography

KW - Muscle, Skeletal

KW - Pancreatic Neoplasms

KW - Pancreaticoduodenectomy

KW - Postoperative Complications

KW - Retrospective Studies

KW - Risk Factors

KW - Sarcopenia

KW - Journal Article

U2 - 10.1016/j.nut.2016.04.002

DO - 10.1016/j.nut.2016.04.002

M3 - Article

VL - 32

SP - 1231

EP - 1237

JO - Nutrition International

JF - Nutrition International

SN - 0899-9007

IS - 11-12

ER -