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Impact of sarcopenia on recurrent biliary obstruction after insertion of self‐expandable metallic stent in patients with malignant biliary obstruction
Author(s) -
Koya Yudai,
Shibata Michihiko,
Oe Shinji,
Honma Yuichi,
Nebuya Satoru,
Miyagawa Koichiro,
Yoshikawa Ichiro,
Harada Masaru
Publication year - 2021
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.970
Subject(s) - sarcopenia , medicine , hazard ratio , proportional hazards model , gastroenterology , cumulative incidence , stent , incidence (geometry) , confidence interval , body mass index , surgery , mathematics , geometry , transplantation
Background/Purpose Recurrent biliary obstruction (RBO) after self‐expandable metallic stent (SEMS) insertion is a big problem in patients with unresectable malignant biliary obstruction (MBO). Sarcopenia is associated with poor prognosis in patients with malignancies. The purpose of this study is to clarify the relationship between RBO and sarcopenia. Methods Forty‐six patients with normal psoas muscle mass index (PMI) and 55 with low PMI were enrolled, based on PMI cut‐off values. We analyzed the cumulative incidences and predictors of RBO, considering death without RBO to be a competing risk. Results In the Kaplan‐Meier analysis, the 60‐, 180‐, and 360‐day cumulative incidence rates of RBO were 0.0%, 12.2%, and 22.0% in the normal PMI group, as compared to 4.0%, 31.1%, and 55.0% in the low PMI group, respectively (log‐rank P = .003). In competing risk analysis, the incidences were 2.9%, 2.9%, and 7.1% in the normal PMI group, as compared to 13.7%, 34.8%, and 51.7% in the low PMI group, respectively ( P < .001). In multivariate Cox regression and Fine‐Gray's analyses, hazard ratios of low PMI for RBO were 4.593 (95% confidence interval 1.673‐12.61, P = .003) and 4.980 (2.045‐12.13, P < .001), respectively. Conclusions Sarcopenia in MBO was an independent risk factor for RBO.