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

Le résumé fourni par la source

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.

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