Objective: to evaluate the impact of probable sarcopenia (PS) on the survival of oncological patients submitted to major surgeries. Method: prospective cohort bicentrical study enrolling adult oncological patients submitted to major surgeries at Cancer Hospital and Santa Casa de Misericordia in Cuiabá-MT. The main endpoint was the verification of postoperative death. Demographic and clinical data was collected. PS was defined as the presence of 1) sarcopenia risk assessed by SARC-F questionnaire and 2) low muscle strength measured by dynamometry. The cumulative mortality rate was calculated for patients with either PS or non PS using Kaplan Meier curve. The univariate and multivariate Cox regression model was used to evaluate the association of mortality with various investigated confounding variables. Results: a total of 220 patients with a mean (SD) age of 58.7±14.0 years old, 60.5% males participated of the study. Patients with PS had higher risk to postoperative death (RR=5.35 95%CI 1.95-14.66; p=0,001) and for infectious complications (RR=2.45 95%CI 1.12-5.33; p=0.036). The 60 days mean survival was shorter for patients with PS: 44 (IQR=32-37) vs 58 (IQR=56-59) days (log rank <0,001). The Cox multivariate regression showed that PS was an independent risk factor (HR=5.8 95%CI 1.49-22.58; p=0.011) for mortality. Conclusion: patients bearing PS submitted to major oncological surgery have less probability of short term survival and preoperative PS is an independent risk for postoperative mortality.

Introdução: Pacientes cirúrgicos, que apresentam risco nutricional ou de sarcopenia, podem evoluir com piores desfechos no pós-operatório. Objetivo: Investigar se existe associação entre o risco nutricional e a sarcopenia com complicações e mortalidade no pós-operatório de pacientes oncológicos submetidos a cirurgias de grande porte. Método: Estudo biocêntrico de coorte, prospectivo, realizado com 220 pacientes oncológicos adultos, submetidos a operações de grande porte no Hospital de Câncer e na Santa Casa de Misericórdia em Cuiabá, Mato Grosso. Os pacientes foram classificados com ou sem risco nutricional pela Nutritional Risk Screening 2002 e de sarcopenia segundo o questionario Strength, Assistance with walking, Rise from a chair, Climb stairs - and Falls, no pré-operatório. As variáveis de desfecho foram complicações infecciosas e óbito no pós-operatório. Resultados: Os pacientes com risco nutricional mostraram maior risco de complicações infecciosas (24,6 vs. 5,1%; RR=4,8 IC95% 1,94-12; p<0,001) e de óbito (11,5 vs. 1,0%; RR=11,2 IC95%1,5-84,0; p=0,002) no pós-operatório, quando comparados aos sem risco nutricional. Não houve associação do risco de sarcopenia com a presença de complicações infecciosas e óbito ao longo do período pós-operatório (p>0,05). Conclusão: Os pacientes oncológicos em risco nutricional foram aqueles que apresentaram maior risco de complicações infecciosas e de óbito no pós-operatório, quando comparados aos sem risco nutricional ou em risco de sarcopenia.

Objectives : to investigate the impact of oncological surgical procedures on the muscle function of patients with and without nutritional risk. Methods: cross-sectional study conducted with cancer patients undergoing major operations between July 2018 to March 2019 in Cuiabá, Mato Grosso, Brazil. Patients were assessed preoperatively for the nutritional risk by the Nutricional Risk Screening-2002, and handgrip strength (FPP) was assessed both on the pre- and 2nd and 5th postoperative days (PO). Results: 92 patients were evaluated, of whom 55.4% were men and 44.6% women, with a mean age (SD) of 64 (10.81) for patients at risk and 51 (12.99) for patients without nutritional risk. The preoperative nutritional risk evaluation indicated that 34.8% of the patients had no risk and 65.2% had a nutritional risk. The FPP was lower (p = 0.008) in the group with nutritional risk in the preoperative period. In both groups, there was a significant drop in FPP on the 2nd PO day. The preoperative FPP compared with the 2nd PO FPP was more pronounced in patients without nutritional risk (p = 0.039). Patients with nutritional risk had a longer hospital stay (p = 0.049). Conclusion: surgical trauma causes loss of muscle function in the early PO. Patients without nutritional risk have a more significant decrease in muscle strength after surgical oncological procedures than those with nutritional risk. These results may infer the need to implement pre-habilitation in all patients who will undergo major oncological procedures.