Sarcopenia as a Predictor of Short- and Long-Term Outcomes in Patients Surgically Treated for Malignant Pleural Mesothelioma

• Published in: Cancers Vol. 14; no. 15; p. 3699
• Main Authors: Faccioli, Eleonora, Terzi, Stefano, Giraudo, Chiara, Zuin, Andrea, Modugno, Antonella, Labella, Francesco, Zambello, Giovanni, Lorenzoni, Giulia, Schiavon, Marco, Gregori, Dario, Pasello, Giulia, Calabrese, Fiorella, Dell’Amore, Andrea, Rea, Federico
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 29-07-2022; MDPI
• Subjects: Asbestos; Chemotherapy; Complications; Diaphragm (Anatomy); Histology; Hospitals; Length of stay; Medical imaging; Medical prognosis; Mesothelioma; Morbidity; Muscles; Open source software; Patients; Population; Postoperative; Radiation therapy; Rehabilitation; Sarcopenia; Surgery; Survival; Thoracic surgery; Tomography; Tumors
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers14153699

Surgery for malignant pleural mesothelioma (MPM) should be reserved only for patients who have a good performance status. Sarcopenia, a well-known predictor of poor outcomes after surgery, is still underinvestigated in MPM. The aim of this study is to evaluate the role of sarcopenia as a predictor of short-and long-term outcomes in patients surgically treated for MPM. In our analysis, we included patients treated with a cytoreductive intent in a multimodality setting, with both pre- and post-operative CT scans without contrast available. We excluded those in whom a complete macroscopic resection was not achieved. Overall, 86 patients were enrolled. Sarcopenia was assessed by measuring the mean muscular density of the bilateral paravertebral muscles (T12 level) on pre-and post-operative CTs; a threshold value of 30 Hounsfield Units (HU) was identified. Sarcopenia was found pre-operatively in 57 (66%) patients and post-operatively in 61 (74%). Post-operative sarcopenic patients had a lower 3-year overall survival (OS) than those who were non-sarcopenic (34.9% vs. 57.6% p = 0.03). Pre-operative sarcopenia was significantly associated with a higher frequency of post-operative complications (65% vs. 41%, p = 0.04). The evaluation of sarcopenia, through a non-invasive method, would help to better select patients submitted to surgery for MPM in a multimodality setting.