Risk factors for progressive sarcopenia 6 months after complete resection of lung cancer : What can thoracic surgeons do against sarcopenia?

• Material Type: 博士論文
• ISSN: 2072-1439
• Title: Risk factors for progressive sarcopenia 6 months after complete resection of lung cancer : What can thoracic surgeons do against sarcopenia?
• Volume: 12 3
• Author/Editor: Nagata, Masashi; 永田, 仁
• Author Heading: Nagata, Masashi; 永田, 仁
• Publication, Distribution, etc.: University of the Ryukyus
• Publication Date: 2019-12-20
• Publication Date (W3CDTF): 2019-12-20
• Periodical title: Journal of Thoracic Disease
• Degree grantor/type: 琉球大学
• Date Granted: 2020-03-24
• Date Granted (W3CDTF): 2020-03-24
• Dissertation Number: 甲第508号
• Degree Type: 博士(医学)
• Conferring No. (Dissertation): 医研第508号
• Text Language Code: eng
• Subject Heading: Lung cancer; surgery; chronic obstructive pulmonary disease (COPD); gastric cancer; operation time
• Target Audience: 一般
• Note (General): Background: Our previous report described how postoperative progression of sarcopenia predicted longterm prognosis after complete resection of non-small cell lung cancer (NSCLC) in heavy smokers. However, there are currently no effective means to treat progressive sarcopenia. In this study, we aimed to confirm our previous findings in a larger population and to identify factors associated with postoperative progression of sarcopenia to propose possible preventative measures.Methods: This retrospective study analyzed the data of 1,095 patients who underwent curative lobar resection for NSCLC at Kanagawa Cancer Center. We divided patients into four groups according to sex and Brinkman index (BI) above or below 600. Six-month postoperative changes in the skeletal muscle index (SMI) were calculated and associations between clinicopathological factors including changes in SMI and mortality from postoperative 6 months were examined. Only in groups in which postoperative depletion of SMI was shown to be associated with the prognosis, we identified clinicopathological factors associated with depletive SMI.Results: The overall survival rates of 1,095 patients were 89.8% and 82.5% at 3 and 5 years, respectively. The median 6-month change in SMI was –3.4% (range, −22.3% to +17.9%). Multivariate analysis revealed that poor prognosis was independently predicted by a large reduction in the SMI (cut-off value: −10%) in males with a BI ≥600. In 391 heavy-smoking males, factors associated with a postoperative change in SMI ≤−10% were history of other cancers (including gastric cancer) low forced expiratory volume in one second (FEV 1.0, cut-off value: 1,870 mL), and prolonged operation time (cut-off value: 200 minutes).Conclusions: Perioperative measures to prevent postoperative sarcopenia are appropriate for heavy smokers. We obtained some clues regarding countermeasures, one of which may be avoiding long-time operation. Further studies including clinical trials to assess perioperative anti-sarcopenia treatments, are needed.; 学位論文
• DOI: info:doi/10.21037/jtd.2020.01.44; https://doi.org/info:doi/10.21037/jtd.2020.01.44
• Persistent ID (NDL): info:ndljp/pid/11538448; https://dl.ndl.go.jp/pid/11538448
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2020-09-07T06:04:08+09:00
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://hdl.handle.net/20.500.12000/46625; https://u-ryukyu.repo.nii.ac.jp/records/2012571
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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