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Handgrip Strength Predicts Postoperative Pneumonia After Thoracoscopic–Laparoscopic Esophagectomy for Patients with Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Despite advances in minimally invasive surgery, postoperative pneumonia after esophagectomy remains a frequent complication. Sarcopenia, defined as low muscle strength and quantity, has been associated with adverse surgical outcomes in numerous cancers. The recent definition and diagnostic criteria for sarcopenia have emphasized muscle strength rather than muscle quantity as the primary indicator of sarcopenia, although most studies have focused only on muscle quantity. This study aimed to determine the association of muscle strength and quantity with postoperative pneumonia after thoracoscopic–laparoscopic esophagectomy (TLE).

Methods

This retrospective, single-center, observational study investigated 161 men undergoing TLE for esophageal cancer between May 2017 and October 2019. Handgrip strength (HGS) and skeletal muscle mass index (SMI) were used respectively as proxy for muscle strength and quantity. The SMI was assessed using preoperative computed tomography at the L3 vertebral level. Predictors of postoperative pneumonia were determined using multivariate analysis.

Results

The study subjects had TLE performed for squamous cell carcinoma (n = 131), adenocarcinoma (n = 24), and other cancers (n = 6). Postoperative pneumonia developed in 28 patients (17.4%). In the multivariate analysis, HGS was significantly associated with postoperative pneumonia (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.08–1.35; p = 0.001]. No association was found between SMI and postoperative pneumonia (p = 0.964). Comparison of the areas under the receiver operating characteristic curves for postoperative pneumonia prediction showed that the value for HGS was significantly higher than for SMI (0.79 vs 0.65, respectively; p = 0.012).

Conclusions

Low HGS was a significant predictor of postoperative pneumonia after TLE for esophageal cancer.

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Acknowledgements

We thank Jane Charbonneau, DVM, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Division of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan

    Daisuke Kurita MD, Junya Oguma MD, PhD, Koshiro Ishiyama MD, Yuki Hirano MD, PhD, Jun Kanamori MD, PhD & Hiroyuki Daiko MD, PhD, FACS

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  1. Daisuke Kurita MD
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  2. Junya Oguma MD, PhD
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  3. Koshiro Ishiyama MD
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  5. Jun Kanamori MD, PhD
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Correspondence to Hiroyuki Daiko MD, PhD, FACS.

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Kurita, D., Oguma, J., Ishiyama, K. et al. Handgrip Strength Predicts Postoperative Pneumonia After Thoracoscopic–Laparoscopic Esophagectomy for Patients with Esophageal Cancer. Ann Surg Oncol 27, 3173–3181 (2020). https://doi.org/10.1245/s10434-020-08520-8

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  • DOI: https://doi.org/10.1245/s10434-020-08520-8

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