JAMA Surg: Muscle reduction is an important factor in the prognosis of patients after liver tumor removal.

Retrospective studies have shown that muscle reduction has a significant effect on the prognostication of patients after the removal of malignant liver tumors, but the evidence is limited to small retrospective studies and lacks quantitative criteria for muscle reduction.
recently examined the predictive effect of muscle reduction as a prognostic risk factor 90 days after the removal of malignant liver tumors.
study, conducted in Italy, involved 234 patients who under had a liver excision due to malignant tumors, respectively, under a preoperative grip test and skeletal muscle index (SMI) assessment.
the results, patients were divided into four groups: Group A (normal muscle mass and strength), Group B (reduced muscle strength), Group C (decreased muscle mass) and Group D (reduced muscle mass and strength).
of the study was 90 days of morbidity, with secondary results including 90 days of mortality, hospitalization and re-admission rates.
234 patients, with an average age of 66.50 years and 158 men (67.5 per cent).
patients underwent 64 large liver excisions and 170 small liver excisions.
SMI for the entire population was 46.22cm/m2.
hand grip is 30.80kg.
90-day morbidity was statistically significantly higher in patients in Group D (51.5% vs C 38.7%, Group B 23.1% and Group A 6.4%).
Compared to other groups, patients in Group D were hospitalized longer (10 days vs C 8 days, Group B 9 days, Group A 6 days) and had a higher re-admission rate (8.8% vs C group 5.3%, Group B 7.7%, Group A 0%).
muscle reduction, venous hypertension, cirrhosis of the liver and bile reconstruction were independent risk factors associated with the 90-day morbidity rate.
study suggests that muscle loss is associated with adverse outcomes after liver excision of malignant tumors.
in order to better classify patients and minimize the risk of onset, muscle and grip assessments should be conducted at the first clinical visit.
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