Muscle Loss May Predict Surgical Complications in Mesothelioma

Muscle Loss May Predict Surgical Complications in Mesothelioma

Age-related muscle loss may be a predictor of negative mesothelioma outcomes after surgery. The news might help patients and doctors make better treatment decisions.

Researchers at the University Hospital of Padova in Italy say they found a link. They connected sarcopenia—muscle loss associated with aging—to poor outcomes after surgery.

The bottom line: muscle loss means more negative outcomes after surgery.

Surgery for Mesothelioma Cancer

Malignant pleural mesothelioma is an aggressive asbestos-related tumor with a poor prognosis. Surgery is often considered in the context of multimodality treatment. There are a variety of surgical procedures and treatments for pleural mesothelioma.

HIPEC stands for hyperthermic intraperitoneal chemotherapy. “Intraperitoneal” means that the treatment is placed inside the abdominal cavity. “Hyperthermic chemotherapy” means that the chemotherapy is heated above normal body temperature. It is a procedure used to treat mesothelioma. Heated and concentrated chemotherapy is placed directly in the surgical cavity during surgery.

In recent years, HIPEC has become the standard of care for peritoneal mesothelioma. HIPEC has improved the prognosis for many patients with this deadly cancer. But surgery has its own risks. Not everyone responds well to this extensive and risky abdominal surgery.

Predicting negative outcomes of surgery was the focus of the new Italian study, published this week in the Cancers journal.

Sarcopenia and Mesothelioma Outcomes

Significant muscle loss is one of the most common and serious cancer-related symptoms. It is strongly connected to a poor prognosis in patients with advanced disease.

Sarcopenia is a well-established predictor of negative outcomes in some diagnoses. But is not well investigated in malignant pleural mesothelioma. The aim of a new study was to look at the prognostic power of muscular loss on surgical outcomes. They looked at patients with malignant pleural mesothelioma.

Sarcopenia can be evaluated by measuring muscle strength. This could be with a hand grip test and a chair stand test. Muscle quantity can be measured using computed tomography (CT) and magnetic resonance imaging (MRI). Or it can also be measured by physical performance with a gait speed and walking test.

The team found that sarcopenia strongly affects the patient. It affects the risk of post-surgery complications and long-term survival after surgery. The study looked at 86 malignant pleural mesothelioma patients pre- and post-surgery.

Sarcopenia was found pre-operatively in 66% of the patients. And it was found post-operatively in 74% of patients. Patients with pre-surgery sarcopenia had more post-surgery complications. And patients with significant muscle loss post-surgery had a lower 3-year survival.

The report may offer another way to help doctors select the best candidates for mesothelioma surgery. They also suggest starting dedicated physical therapy programs before surgery.


Faccioli, Eleonora, Stefano Terzi, Chiara Giraudo, Andrea Zuin, Antonella Modugno, Francesco Labella, Giovanni Zambello et al. “Sarcopenia as a Predictor of Short-and Long-Term Outcomes in Patients Surgically Treated for Malignant Pleural Mesothelioma.” Cancers 14, no. 15 (2022): 3699.


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