Abstract
Objective: To investigate the 1-year longitudinal changes in skeletal muscle index (SMI) and muscle quality after surgery for pancreatic cancer, and to identify factors associated with changes in SMI.
Methods: Forty-one patients with pancreatic cancer were included. SMI and muscle quality were assessed using CT images at the L3 level (single-slice) obtained preoperatively and at 2 weeks, 3 months, and 1 year postoperatively. Muscle quality was evaluated using mean CT attenuation and histogram analysis. Factors associated with the rate of change in SMI were examined.
Results: SMI continuously decreased throughout the first postoperative year. In contrast, muscle quality transiently declined at 2 weeks after surgery and tended to recover at 1 year. Mean CT attenuation alone was insufficient to capture changes in muscle quality; however, histogram analysis demonstrated an increased proportion of the HU range corresponding to normal muscle at 1 year after surgery. In multivariable analysis, prealbumin at 3 months postoperatively was independently associated with the rate of change in SMI.
Conclusion: After pancreatic cancer surgery, skeletal muscle mass continued to decline over 1 year, whereas muscle quality may show a recovery trend. Histogram-based analysis may complement the assessment of changes in muscle quality. In addition, postoperative 3-month prealbumin, which may reflect a complex biological condition including nutritional and inflammatory status, was associated with changes in SMI.
