Textbook outcome and nomogram-guided approaches for enhancing surgical success in elderly HCC patients: Deciphering the influence of sarcopenia

• DOI: 10.1007/s13304-024-01992-3
• Publication Date: 2024-10-07T13:03:02Z
• Authors: Jacopo Lanari; Amalia Lupi; Ilaria Billato; Remo Alessandris; Filippo Crimì; Silvia Caregari; Alessia Pepe; Francesco Enrico ...; Alessandro Vitale; Emilio Quaia; Umberto Cillo; Enrico Gringeri
• Keywords: Nomogram

Abstract Sarcopenia, serving as a surrogate for frailty, is clinically significant in liver resection (LR) elderly hepatocellular carcinoma (HCC) patients. Our study aims to assess sarcopenia’s impact, measured by Psoas Muscle Index (PMI), on postoperative outcomes. We retrospectively studied patients aged ≥ 60 years who underwent LR HCC between 2014 and 2018. PMI, derived from preoperative CT scans, Textbook Outcome (TO) were assessed. A nomogram predicting overall survival (OS) was developed via multivariable analysis. Of the 149 eligible patients, median PMI 7.225 cm 2 /m males 4.882 females, with 37 (24.8%) identified sarcopenic. Mortality significantly associated sarcopenia (HR 2.15; p = 0.032), MELD 10 3.13; 0.001), > 3 nodules 4.97; Clavien–Dindo complications 3.38; < 0.001). Sarcopenic had 5-year OS of 38.8% compared 61% non-sarcopenic individuals ( 0.085). Achieving TO correlated higher 0.01). In sarcopenic cases, absence emerged limiting factor. failing achieve worse TO-achieving counterparts (5-year 18.5%; 0.00039). Sarcopenia emerges prognostic factor outcomes Postoperative may compromise oncological