Impact of Osteosarcopenia on Peritoneal Cancer Index and Major Complications in Patients with Peritoneal Carcinomatosis

Öz

This study aimed to evaluate the predictive value of osteosarcopenia for the Peritoneal Cancer Index (PCI) and completeness of cytoreduction (CC score) in patients with peritoneal carcinomatosis. Additionally, the study investigated the impact of osteosarcopenia on major postoperative complications. A total of 80 patients who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) between January 2015 and October 2024 were retrospectively analyzed. Patients were divided into two groups based on the presence of osteosarcopenia. Demographic characteristics, PCI and CC scores, nutritional and inflammatory markers, and postoperative outcomes were compared. Major postoperative complications were defined as Clavien–Dindo grade ≥3. Independent predictors of major complications were identified using multivariable logistic regression analysis. Osteosarcopenia was detected in 22 patients (27.5%). The proportion of patients with PCI ≥5 was significantly higher in the osteosarcopenia group compared with those without osteosarcopenia (86.4% vs. 62.1%; p = 0.041). Nutritional and inflammatory markers, including PNI, CALLY and LCR, were significantly lower in patients with osteosarcopenia (p=0.031; p=0.044; p=0.019, respectively). Major postoperative complications occurred more frequently in the osteosarcopenia group (36.4% vs. 22.4%; p = 0.004). In multivariate analysis, osteosarcopenia (OR 2.45; p=0.021), PCI ≥5 (OR 3.00; p=0.018), and CC-1 cytoreduction (OR 2.00; p=0.043) emerged as independent predictors of major complications.Osteosarcopenia is associated with higher PCI values and serves as an independent risk factor for major postoperative complications. These results suggest that osteosarcopenia can be considered a useful biomarker in preoperative risk stratification and surgical decision-making for patients undergoing CRS and HIPEC.

Anahtar Kelimeler

• Osteosarcopenia
• Cytoreductive Surgery
• Hyperthermic Intraperitoneal Chemotherapy
• Prognostic Nutritional Index
• CALLY.

Peritoneal Karsinomatozlu Hastalarda Osteosarkopeninin Peritoneal Kanser İndeksi ve Majör Komplikasyonlar Üzerindeki Etkisi

Öz

Bu çalışma, peritoneal karsinomatozlu hastalarda osteosarkopeninin Peritoneal Kanser İndeksi (PCI) ve sitoredüksiyonun tamlığı (CC skoru) üzerindeki öngörü değerini değerlendirmeyi amaçladı. Ayrıca osteosarkopeninin majör postoperatif komplikasyonlar üzerindeki etkisi araştırıldı. Ocak 2015–Ekim 2024 tarihleri arasında sitoredüktif cerrahi (CRS) ve hipertermik intraperitoneal kemoterapi (HIPEC) uygulanan 80 hasta retrospektif olarak incelendi. Hastalar osteosarkopeni varlığına göre iki gruba ayrıldı ve demografik veriler, PCI ve CC skorları, beslenme-inflamasyon belirteçleri ile postoperatif sonuçlar karşılaştırıldı. Majör postoperatif komplikasyonlar Clavien–Dindo ≥3 olarak tanımlandı. Bağımsız belirleyiciler çok değişkenli lojistik regresyon ile değerlendirildi. Osteosarkopeni 22 hastada (%27,5) saptandı. PCI ≥5 oranı osteosarkopeni grubunda anlamlı derecede daha yüksekti (%86,4 vs. %62,1; p=0.041). PNI, CALLY ve LCR değerleri osteosarkopenili hastalarda anlamlı ölçüde daha düşüktü (p=0.031; p=0.044; p=0.019). Majör postoperatif komplikasyon oranı osteosarkopeni grubunda daha fazlaydı (%36,4 vs. %22,4; p=0.004). Çok değişkenli analizde osteosarkopeni (OR 2.45; p=0.021), PCI ≥5 (OR 3.00; p=0.018) ve CC-1 sitoredüksiyon (OR 2.00; p=0.043) majör komplikasyonların bağımsız belirleyicileri olarak bulundu. Sonuç olarak, osteosarkopeni daha yüksek PCI değerleri ile ilişkili olup majör postoperatif komplikasyonlar için bağımsız bir risk faktörüdür. Bu bulgular, osteosarkopeninin CRS ve HIPEC uygulanacak hastalarda preoperatif risk sınıflandırması ve cerrahi karar verme süreçlerinde yararlı bir biyobelirteç olarak kullanılabileceğini göstermektedir.

Anahtar Kelimeler

• Osteosarkopeni
• Sitoredüktif cerrahi
• Hipertermik İntraperitoneal Kemoterapi
• Prognostik Nutrisyonal İndeks
• CALLY

Kaynakça

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