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Lee JY, Oh EG, Jang Y, Lee J, Hyung W, Kim YC. Effectiveness of self-management program for gastric cancer patients: A randomized controlled trial comparing gain vs. loss message framing. PATIENT EDUCATION AND COUNSELING 2024; 128:108364. [PMID: 39047331 DOI: 10.1016/j.pec.2024.108364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 05/13/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE This study aims to evaluate the effectiveness of a self-management program using gain/loss-framed messages in patients with gastric cancer. METHODS In this randomized controlled trial, 69 patients with gastric cancer who underwent gastrectomy at a university hospital were assigned to the gain- or loss-framed message group. The self-management program consisted of: 1) face-to-face education, 2) gain/loss-framed text messages, and 3) self-monitoring of health behaviors. Health outcomes (i.e., nutritional status, physical activity, exercise intensity, and distress), and health behaviors (i.e., dietary habits, physical activity performance, and distress management) were measured, and a generalized estimating equation was used for the analysis. RESULTS Nutritional status and dietary habits in the loss framed message group were statistically higher after the intervention compared to the counterpart (β = -1.72, p = .049; β = 0.36, p = .033, respectively). There was no time-group interaction effect on physical activity, exercise intensity, physical activity performance, distress or distress management. CONCLUSIONS A self-management program employing loss-framed messages was effective in promoting nutrition-related self-management among patients with gastric cancer. PRACTICE IMPLICATIONS Message-framing is an effective communication technique that can be easily used in clinical settings, and a loss-message-framing strategy may enhance nutrition-related self-management in patients with gastric cancer.
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Affiliation(s)
- Ji Yea Lee
- College of Nursing, Ajou University, 206, World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, South Korea
| | - Eui Geum Oh
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea; Mo-IM KIM Nursing Research Institute College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea.
| | - Yeonsoo Jang
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea; Mo-IM KIM Nursing Research Institute College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Jiyeon Lee
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea; Mo-IM KIM Nursing Research Institute College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Woojin Hyung
- Department of Surgery, College of Medicine, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Yong-Chan Kim
- College of Communication, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
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Xu X, Liu WH, Yates P. Changes in Skeletal Muscle Mass in the First 3 Months Following Gastrointestinal Cancer Surgery: A Prospective Study. Ann Surg Oncol 2024:10.1245/s10434-024-16109-8. [PMID: 39230851 DOI: 10.1245/s10434-024-16109-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Surgical resection is the primary treatment for gastrointestinal (GI) cancers, but postoperative skeletal muscle loss (SML) is common and linked to poor prognosis. This study aims to identify patterns of muscle change, examine its association with quality of life (QoL), and explore predictors of SML in the first 3 months. PATIENTS AND METHODS A prospective cohort study was conducted on patients newly diagnosed with GI cancer and undergoing surgery in China between September 2021 and May 2022. Skeletal muscle mass (SMM) and QoL were assessed at admission, 7 days, 1 month, and 3 months post-surgery. Demographic, clinical data, and biomarkers were collected. Missing data were imputed using multiple imputation. Data were analyzed using growth mixture modelling, bivariate analyses, and logistic regression. RESULTS A total of 483 patients completed baseline assessment. Of the 242 patients with complete muscle assessments, 92% experienced SML. Three distinct patterns of muscle change were identified: 57% had normal preoperative SMM with mild postoperative SML, 16% had low preoperative SMM with moderate SML, and 27% had normal preoperative mass but severe postoperative SML. Moderate/severe SML was associated with more postoperative complications, poorer health, and higher symptom burden. Independent predictors included advanced age, preoperative sarcopenia, advanced cancer stage, and low prognostic nutrition index (PNI ≤ 45). The results did not change when using imputed values. CONCLUSIONS Although SML is prevalent, patterns of muscle change are heterogeneous among patients. Advanced age, preoperative sarcopenia, advanced cancer stage, and cancer-related inflammation are predictors for moderate/severe SML, highlighting the need for early detection and management.
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Affiliation(s)
- Xinyi Xu
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Wei-Hong Liu
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Centre for Healthcare Transformation, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Kato T, Oshikiri T, Koterazawa Y, Goto H, Sawada R, Harada H, Urakawa N, Hasegawa H, Kanaji S, Yamashita K, Matsuda T, Kakeji Y. Effectiveness of long-term tube feeding intervention in preventing skeletal muscle loss after minimally invasive esophagectomy. Surg Today 2024; 54:606-616. [PMID: 38150018 DOI: 10.1007/s00595-023-02787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/03/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE Esophageal cancer is a lethal tumor typically treated by neoadjuvant chemotherapy and surgery. For patients undergoing esophagectomy, postoperative enteral nutrition is important in preventing complications. Sarcopenia is associated with poor postoperative outcomes in esophageal cancer. In this study, we evaluated the benefits of tube feeding intervention and compared its short- and long-term outcomes in patients who underwent esophagectomy. METHODS Propensity score matching was performed in 303 patients who underwent esophagectomy at Kobe University Hospital between 2010 and 2020. Patients were divided into feeding and nonfeeding jejunostomy tube groups (n = 70 each). The feeding jejunostomy tube group was further divided into long-term (≥ 60 days) and short-term (< 60 days) subgroups. The groups were then retrospectively compared regarding postoperative albumin levels, body weight, and psoas muscle area and volume. RESULTS In the long-term feeding jejunostomy tube group, anastomotic leakage (p = 0.013) and left laryngeal nerve palsy (p = 0.004) occurred frequently. There were no significant between-group differences in postoperative albumin levels, body weight, or psoas muscle area. However, significant psoas muscle volume recovery was confirmed in the long-term jejunostomy tube group at 6 months postoperatively (p = 0.041). CONCLUSIONS Tube feeding intervention after minimally invasive esophagectomy may attenuate skeletal muscle mass loss and help prevent sarcopenia.
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Affiliation(s)
- Takashi Kato
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan.
| | - Yasufumi Koterazawa
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Hironobu Goto
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Ryuichiro Sawada
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Hitoshi Harada
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Naoki Urakawa
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Hiroshi Hasegawa
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Shingo Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Kimihiro Yamashita
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Takeru Matsuda
- Division of Minimally Invasive Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
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Tu W, Niu Y, Su P, Liu D, Lin F, Sun Y. Establishment of a risk prediction model for residual low back pain in thoracolumbar osteoporotic vertebral compression fractures after percutaneous kyphoplasty. J Orthop Surg Res 2024; 19:41. [PMID: 38184651 PMCID: PMC10771681 DOI: 10.1186/s13018-024-04528-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVE This study aims to identify potential independent risk factors for residual low back pain (LBP) in patients with thoracolumbar osteoporotic vertebral compression fractures (OVCFs) following percutaneous kyphoplasty (PKP) treatment. Additionally, we aim to develop a nomogram that can accurately predict the occurrence of residual LBP. METHODS We conducted a retrospective review of the medical records of thoracolumbar OVCFs patients who underwent PKP treatment at our hospital between July 2021 and December 2022. Residual LBP was defined as the presence of moderate or greater pain (VAS score ≥ 4) in the low back one day after surgery, and patients were divided into two groups: the LBP group and the non-LBP group. These patients were then randomly allocated to either a training or a validation set in the ratio of 7:3. To identify potential risk factors for residual LBP, we employed lasso regression for multivariate analysis, and from this, we constructed a nomogram. Subsequently, the predictive accuracy and practical clinical application of the nomogram were evaluated through a receiver operating characteristic (ROC) curve, a calibration curve, and a decision curve analysis (DCA). RESULTS Our predictive model revealed that five variables-posterior fascial oedema, intravertebral vacuum cleft, time from fracture to surgery, sarcopenia, and interspinous ligament degeneration-were correlated with the presence of residual LBP. In the training set, the area under the ROC was 0.844 (95% CI 0.772-0.917), and in the validation set, it was 0.842 (95% CI 0.744-0.940), indicating that the model demonstrated strong discriminative performance. Furthermore, the predictions closely matched actual observations in both the training and validation sets. The decision curve analysis (DCA) curve suggested that the model provides a substantial net clinical benefit. CONCLUSIONS We have created a novel numerical model capable of accurately predicting the potential risk factors associated with the occurrence of residual LBP following PKP in thoracolumbar OVCFs patients. This model serves as a valuable tool for guiding specific clinical decisions for patients with OVCFs.
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Affiliation(s)
- Weiqiao Tu
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Yanping Niu
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Peng Su
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Di Liu
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
| | - Fanguo Lin
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu, People's Republic of China.
| | - Yongming Sun
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu, People's Republic of China
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Kamiya A, Hayashi T, Sakon R, Ishizu K, Wada T, Otsuki S, Yamagata Y, Katai H, Yoshikawa T. Acceleration of sarcopenia in elderly patients who develop asymptomatic pneumonia shadow within one year after surgery for early gastric cancer. BMC Surg 2023; 23:232. [PMID: 37568129 PMCID: PMC10422834 DOI: 10.1186/s12893-023-02096-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/03/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Although early gastric cancer is curable with local treatment, the overall survival in elderly patients did not reach 80% at five years after surgery. The major cause of death in elderly patients with early gastric cancer is not cancer itself but is related to postoperative sarcopenia. Elderly patients frequently develop postoperative asymptomatic pneumonia shadow, which is associated with a poor prognosis. However, why asymptomatic pneumonia shadow worsens the prognosis remains unclear. We investigated whether sarcopenia is accelerated in patients who developed asymptomatic pneumonia shadow. METHODS We retrospectively examined patients of > 75 years of age who underwent R0 gastrectomy for gastric cancer and were diagnosed with T1 disease at National Cancer Center Hospital between 2005 and 2012. The diagnosis of asymptomatic pneumonia shadow was defined by diagnostic findings of pneumonia (consolidation type, reticular type, and nodular type) which were newly observed on chest computed tomography performed one year after surgery in comparison to preoperative computed tomography. Postoperative muscle loss was assessed by a computed tomography-based analysis using the L3 skeletal muscle index before and two years after surgery and the rate of decrease was calculated. Patients were classified into two groups according to the rate of decrease (cut-off value: 10%). RESULTS Of the 3412 patients who underwent gastrectomy in our hospital during the study period, 142 were included in this study. Asymptomatic pneumonia shadow was found in 26 patients (18%). Patients who developed asymptomatic pneumonia shadow showed a significantly greater loss of muscle volume in comparison to patients who did not develop asymptomatic pneumonia shadow. In the multivariate analysis, total gastrectomy and asymptomatic pneumonia shadow were the independent risk factors for severe muscle loss. However, there was no significant difference in prognosis between the two groups. CONCLUSIONS Sarcopenia was accelerated in elderly patients who developed asymptomatic pneumonia shadow after surgery for early gastric cancer. However, the poor prognosis in these patients may not be related to accelerated sarcopenia.
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Affiliation(s)
- Ayako Kamiya
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tsutomu Hayashi
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Ryota Sakon
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kenichi Ishizu
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takeyuki Wada
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sho Otsuki
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukinori Yamagata
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hitoshi Katai
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takaki Yoshikawa
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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Gau RY, Tsai HI, Yu MC, Chan KM, Lee WC, Wang HE, Wang SF, Cheng ML, Chiu CC, Chen HY, Lee CW. Laparoscopic liver resection is associated with less significant muscle loss than the conventional open approach. World J Surg Oncol 2022; 20:385. [PMID: 36464698 PMCID: PMC9721003 DOI: 10.1186/s12957-022-02854-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/24/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Laparoscopic liver resections (LLR) have been shown a treatment approach comparable to open liver resections (OLR) in hepatocellular carcinoma (HCC). However, the influence of procedural type on body composition has not been investigated. The aim of the current study was to compare the degree of skeletal muscle loss between LLR and OLR for HCC. METHODS By using propensity score matching (PSM) analysis, 64 pairs of patients were enrolled. The change of psoas muscle index (PMI) after the operation was compared between the matched patients in the LLR and OLR. Risk factors for significant muscle loss (defined as change in PMI > mean change minus one standard deviation) were further investigated by multivariate analysis. RESULTS Among patients enrolled, there was no significant difference in baseline characteristics between the two groups. The PMI was significantly decreased in the OLR group (P = 0.003). There were also more patients in the OLR group who developed significant muscle loss after the operations (P = 0.008). Multivariate analysis revealed OLR (P = 0.023), type 2 diabetes mellitus, indocyanine green retention rate at 15 min (ICG-15) > 10%, and cancer stage ≧ 3 were independent risk factors for significant muscle loss. In addition, significant muscle loss was associated with early HCC recurrence (P = 0.006). Metabolomic analysis demonstrated that the urea cycle may be decreased in patients with significant muscle loss. CONCLUSION LLR for HCC was associated with less significant muscle loss than OLR. Since significant muscle loss was a predictive factor for early tumor recurrence and associated with impaired liver metabolism, LLR may subsequently result in a more favorable outcome.
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Affiliation(s)
- Ruoh-Yun Gau
- grid.454211.70000 0004 1756 999XDivision of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, 33305 Taiwan
| | - Hsin-I Tsai
- grid.145695.a0000 0004 1798 0922Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan ,grid.145695.a0000 0004 1798 0922College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan ,grid.454211.70000 0004 1756 999XDepartment of Anesthesiology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Ming-Chin Yu
- grid.454211.70000 0004 1756 999XDepartment of Anesthesiology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan ,grid.413801.f0000 0001 0711 0593Division of General Surgery, Department of Surgery, New Taipei Municipal Tu-Cheng Hospital (built and operated by Chang Gung Medical Foundation), Tu-Cheng, New Taipei City, Taiwan
| | - Kun-Ming Chan
- grid.454211.70000 0004 1756 999XDivision of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, 33305 Taiwan ,grid.145695.a0000 0004 1798 0922College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan
| | - Wei-Chen Lee
- grid.454211.70000 0004 1756 999XDivision of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, 33305 Taiwan ,grid.145695.a0000 0004 1798 0922College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan
| | - Haw-En Wang
- grid.454211.70000 0004 1756 999XDepartment of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Sheng-Fu Wang
- grid.454211.70000 0004 1756 999XDepartment of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Mei-Ling Cheng
- grid.145695.a0000 0004 1798 0922Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Guishan, Taoyuan, Taiwan ,grid.145695.a0000 0004 1798 0922Department of Biomedical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan ,grid.454211.70000 0004 1756 999XClinical Metabolomics Core Laboratory, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Chien-Chih Chiu
- grid.454211.70000 0004 1756 999XDepartment of Nursing, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Hsin-Yi Chen
- grid.145695.a0000 0004 1798 0922College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan ,grid.454211.70000 0004 1756 999XDepartment of Nursing, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan ,grid.454211.70000 0004 1756 999XDepartment of Cancer Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Chao-Wei Lee
- grid.454211.70000 0004 1756 999XDivision of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, 33305 Taiwan ,grid.145695.a0000 0004 1798 0922Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan ,grid.145695.a0000 0004 1798 0922College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan
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Luo Y, Jiang T, Guo H, Lv F, Hu Y, Zhang L. Osteoporotic vertebral compression fracture accompanied with thoracolumbar fascial injury: risk factors and the association with residual pain after percutaneous vertebroplasty. BMC Musculoskelet Disord 2022; 23:343. [PMID: 35410277 PMCID: PMC8996573 DOI: 10.1186/s12891-022-05308-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/04/2022] [Indexed: 12/25/2022] Open
Abstract
Background To explore the risk factors involved in the induction of thoracolumbar fascia (TLF) injury by osteoporotic vertebral compression fracture (OVCF), and the association between the residual pain after percutaneous vertebroplasty (PVP) and fascial injury. Methods A total of 81 patients with single-segment OVCF, treated between January 2018 and January 2020 were included. The patients were grouped according to the existence of TLF injury. The patients’ general, clinical, and imaging data were accessed. Results There were 47 patients in the TLF group and 34 in the non-injury group (NTLF group). In the TLF group, BMI (Body mass index) was significantly lower, while the prevalence of hypertension and sarcopenia were significantly higher (P < 0.05). The vertebral compression degree was higher, and the kyphosis angle of the injured vertebra was greater in the TLF group (P < 0.05). Cobb’s angle was not significantly different between groups. At 3-d after the operation, the VAS (Visual analogue scale) was 4.64 ± 1.78 and 3.00 ± 1.71, and the ODI (Oswestry disability index) was 67.44 ± 11.37% and 56.73 ± 10.59% in TLF and NTLF group, respectively (P < 0.05). However, at 3-m after the operation, the differences in the VAS score and the ODI between groups were not statistically significant. The area of fascial edema was not significantly associated with the pre- and post-operative VAS or ODI, but was positively correlated with the vertebral body compression degree (R = 0.582, P = 0. 029). Conclusion Residual back pain after PVP is associated with TLF injury. Low BMI, hypertension and sarcopenia are risk factors of TLF injury, and sarcopenia may be the major factor.
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Affiliation(s)
- Yang Luo
- Department of Orthopedics, The First Medical Center of PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Tianyu Jiang
- Department of Rehabilitation, The Second Medical Center of PLA General Hospital, Beijing, 100853, P. R. China
| | - Hui Guo
- Department of Orthopedics, The First Medical Center of PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, P. R. China
| | - Faqin Lv
- Department of Ultrasound, The Third Medical Center of PLA General Hospital, Beijing, 100853, P. R. China
| | - Ying Hu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, 518055, P. R. China
| | - Lihai Zhang
- Department of Orthopedics, The First Medical Center of PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, P. R. China.
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Matsunaga T, Satio H, Miyauchi W, Shishido Y, Miyatani K, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Impact of skeletal muscle mass in patients with recurrent gastric cancer. World J Surg Oncol 2021; 19:170. [PMID: 34116681 PMCID: PMC8196500 DOI: 10.1186/s12957-021-02283-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We retrospectively examined the relationship among skeletal muscle mass index (SMI), prognosis, and chemotherapy side effects in patients with recurrent gastric cancer (RGC). METHODS Sixty-seven patients who developed recurrence after undergoing curative gastrectomy for gastric cancer at Tottori University Hospital and received palliative chemotherapy were included in this study. Pretreatment computed tomography was performed to measure the skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra. We focused on haematologic toxicity (neutropenia, thrombocytopenia, and anaemia), febrile neutropenia, and gastrointestinal toxicity (diarrhoea, vomiting, and stomatitis) as the side effects of chemotherapy. RESULTS Median SMIs for males and females (43.9 and 34.7 cm2/m2, respectively) were used as cutoff values. The patients were classified into high (SMIHigh; n = 34) and low SMI groups (SMILow; n = 33). The SMILow group included more patients treated with monotherapy (P = 0.016) compared with the SMIHigh group, had a significantly lower number of chemotherapy lines (P = 0.049), and had a significantly higher incidence of grade 3 or 4 side effects (P = 0.010). The median survival rate was significantly higher in the SMIHigh group (17.8 vs 15.8 months; P = 0.034). In the univariate analysis, body mass index, SMI, histological type, and prognostic nutritional index were identified as prognostic indicators. The multivariate analysis identified SMI (P = 0.037) and histological type (P = 0.028) as independent prognostic factors. CONCLUSION The incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow RGC. SMI was a useful prognostic marker of RGC.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Hiroaki Satio
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-cho, Tottori, 680-8517, Japan
| | - Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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