Evidence map›Paper›PMID 27897432›Full record

ArticleJournal of cachexia, sarcopenia and muscle2017

Low skeletal muscle radiation attenuation and visceral adiposity are associated with overall survival and surgical site infections in patients with pancreatic cancer.

David P J van Dijk, Maikel J A M Bakens, Mariëlle M E Coolsen, Sander S Rensen, Ronald M van Dam, Martijn J L Bours, Matty P Weijenberg, Cornelis H C Dejong, Steven W M Olde Damink

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cachexia, sarcopenia and muscle, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05899205 (Patient Recorded Indexing Measurements), which is not on this map. Cited by 128 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 8 pooled it
12.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05899205 recruitingnot on this mapstarted 2021, after this paper: background citation

Patient Recorded Indexing Measurements

TypeobservationalSponsorAcademisch Ziekenhuis MaastrichtRan2021 to 2027Enrolled300ConditionsCachexia, Cancer, Weight, Body
3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 8 syntheses or guidelines pooled it, 250 citations in OpenAlex.

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  9. Body composition measurements and clinical outcomes in patients with resectable pancreatic adenocarcinoma - analysis from SWOG S1505.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2024
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  10. Body Composition Is a Predictor for Postoperative Complications After Gastrectomy for Gastric Cancer: a Prospective Side Study of the LOGICA Trial.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022
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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

David P J van DijkDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Maikel J A M BakensDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Mariëlle M E CoolsenDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Sander S RensenDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Ronald M van DamDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Martijn J L BoursDepartment of Epidemiology, Maastricht University, Maastricht, The Netherlands.
Matty P WeijenbergDepartment of Epidemiology, Maastricht University, Maastricht, The Netherlands.
Cornelis H C DejongDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Steven W M Olde DaminkDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Maastricht University · NLMaastricht University Medical Centre · NLUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCancer cachexia and skeletal muscle wasting are related to poor survival. In this study, quantitative body composition measurements using computed tomography (CT) were investigated in relation to survival, post-operative complications, and surgical site infections in surgical patients with cancer of the head of the pancreas.

methodsA prospective cohort of 199 patients with cancer of the head of the pancreas was analysed by CT imaging at the L3 level to determine (i) muscle radiation attenuation (average Hounsfield units of total L3 skeletal muscle); (ii) visceral adipose tissue area; (iii) subcutaneous adipose tissue area; (iv) intermuscular adipose tissue area; and (v) skeletal muscle area. Sex-specific cut-offs were determined at the lower tertile for muscle radiation attenuation and skeletal muscle area and the higher tertile for adipose tissues. These variables of body composition were related to overall survival, severe post-operative complications (Dindo-Clavien ≥ 3), and surgical site infections (wounds inspected daily by an independent trial nurse) using Cox-regression analysis and multivariable logistic regression analysis, respectively.

resultsLow muscle radiation attenuation was associated with shorter survival in comparison with moderate and high muscle radiation attenuation [median survival 10.8 (95% CI: 8.8-12.8) vs. 17.4 (95% CI: 14.7-20.1), and 18.5 (95% CI: 9.2-27.8) months, respectively; P < 0.008]. Patient subgroups with high muscle radiation attenuation combined with either low visceral adipose tissue or age <70 years had longer survival than other subgroups (P = 0.011 and P = 0.001, respectively). Muscle radiation attenuation was inversely correlated with intermuscular adipose tissue (r

conclusionsLow muscle radiation attenuation was associated with reduced survival, and high visceral adiposity was associated with an increase in surgical site infections. The strong correlation between muscle radiation attenuation and intermuscular adipose tissue suggests the presence of ectopic fat in muscle, warranting further investigation. CT image analysis could be implemented in pre-operative risk assessment to assist in treatment decision-making.

Indexed as

AgedBody CompositionFemaleHumansIntra-Abdominal FatKaplan-Meier EstimateMaleMiddle AgedMuscle, SkeletalPancreatic NeoplasmsSubcutaneous FatSurgical Wound InfectionBody compositionComputed tomographyPancreatic cancerRadiation attenuationSurgical site infectionVisceral adipose tissue

Identifiers

PMID27897432
PMCPMC5377384
OpenAlexW2539910027

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.