Impact of Visceral Obesity and Sarcopenia on Short-Term Outcomes After Colorectal Cancer Surgery

Chen, Weizhe; Chen, Xiao; Ma, Lan; Zhang, Fengmin; Lin, Ji; Zhuang, Cheng‐Le; Yu, Zhen; Chen, Xiaolei; Chen, Xiaoxi

doi:10.1007/s10620-018-5019-2

Cited by 83 publications

(84 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, when analyzing S‐alb and hsCRP in relation to outcome in ESRD, body composition should be considered. It is likely that high CRP and low S‐Alb in part may reflect a state of obese sarcopenia , a condition associated with older age, sedentary life style, and a high mortality rate both in ESRD and other conditions . Indeed, abdominal fat deposition is linked to inflammation, PEW, and increased mortality risk in ESRD .…”

mentioning

confidence: 99%

“…It is likely that high CRP and low S-Alb in part may reflect a state of obese sarcopenia, a condition associated with older age, sedentary life style, and a high mortality rate both in ESRD 36 and other conditions. 37,38 Indeed, abdominal fat deposition is linked to inflammation, PEW, and increased mortality risk in ESRD. 39 Moreover, obese sarcopenia has been linked to anabolic resistance and ectopic muscular fat deposition.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Mukai

Villafuerte

Qureshi

et al. 2018

Seminars in Dialysis

View full text Add to dashboard Cite

Low serum albumin (S-Alb) is a frequent feature of end-stage renal disease (ESRD) that independently predicts mortality. Serum albumin has mainly been considered a biomarker of visceral protein and immunocompetence status, fundamental to nutritional assessment. However, low S-albumin level is associated with persistent systemic inflammation and many bodies of evidence show that S-Alb has a limited role as a marker of nutritional status. We reported that a low S-Alb concentration was an independent risk factor for poor outcome in ESRD only in the presence of systemic inflammation. Moreover, the relationships between inflammatory biomarkers and outcome are confounded also by alterations in body composition (such as obese sarcopenia) and oxidative stress. Taken together, S-Alb alone should not be used as a proxy of the nutritional status in a dialysis patient. Its association with dietary intake is poor and low S-Alb values are most often non-nutritional in origin. When analyzing S-Alb to predict mortality risk in ESRD, it should always be combined with measurement of hsCRP.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Mukai

Villafuerte

Qureshi

et al. 2018

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…Many studies have examined the relationship between obesity and sarcopenia. Chen et al (2018) performed a prospective study looking at obesity and sarcopenia individually and combined before colorectal cancer surgery [9]. When combined, patients had longer hospital stays and higher costs, while sarcopenia alone was an independent risk factor for medical complications [9].…”

Section: Discussionmentioning

confidence: 99%

Is sarcopenia a better predictor of complications than body mass index? Sarcopenia and surgical outcomes in patients with rectal cancer

et al. 2019

View full text Add to dashboard Cite

Aim Sarcopenia, or a reduction of lean muscle mass, is associated with poorer outcomes in cancer patients. Few previous studies have examined this potentially correctable risk factor in patients with locally advanced rectal cancer. Method Skeletal muscle mass index was measured retrospectively on initial staging CT scans of patients undergoing chemoradiation followed by radical resection for rectal cancer for the period 2007–2013. Patients were categorized as sarcopenic or nonsarcopenic and differences in terms of demographics, pre‐, peri‐ and postoperative outcomes were examined. Results Forty‐seven patients were included; their mean age was 59.3 (36–82) years and 61.7% were men. We considered that 55.2% of men and 44.4% of women were sarcopenic; the overall prevalence of sarcopenia was 51.1%. Age, preoperative haemoglobin and albumin were significantly related to sarcopenia. Body mass index (BMI) and obesity (BMI > 30 kg/m2) were not associated with sarcopenia. Blood transfusions were more frequent in sarcopenic patients (P = 0.001). Although readmissions and length of stay were not increased, overall postoperative complications were significantly higher in sarcopenic patients (P = 0.03). Neither BMI nor obesity was associated with postoperative complications. Conclusion Sarcopenia was present in over 50% of patients with locally advanced rectal cancer at diagnosis. It was associated with a higher incidence of both blood transfusion and postoperative complications. BMI did not correlate with these negative outcomes. Sarcopenia may be a better predictor of surgical outcomes than BMI or obesity.

show abstract

“…After the process of selection based on abstract and title and after on the full-text article review ( Fig. 1), we finally included 14 studies assessing the difference in health care costs between individuals with or without sarcopenia [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Sixteen studies were rejected because of duplicate (n = 2) [11,20], wrong outcomes (n = 13) [24][25][26][27][28][29][30][31][32][33][34][35][36] or wrong exposure factor (n = 1) [38].…”

Section: Literature Searchmentioning

confidence: 99%

“…A complete presentation of the characteristics and design of the 14 included studies [10][11][12][13][14][15][16][17][18][19][20][21][22][23] is accessible in Table 3. All studies, specifically regarding their analysis of sarcopenia-related costs, followed a cross-sectional design and was comprised of 50 to 1593 participants.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

The health economics burden of sarcopenia: a systematic review

et al. 2019

View full text Add to dashboard Cite

Despite of better knowledge about sarcopenia, an optimal understanding of its consequences from a public health perspective remains a challenge. Specifically, the economic burden of the illness is unclear. As a support for the public health policy makers and other health actors, our objective was to perform a systematic review of the literature comparing healthcare costs between sarcopenic and non-sarcopenic patients (under the registration number CRD42018099291). A search for relevant articles was conducted on the Medline and Scopus databases. Rigorous eligibility criteria were established (e.g., subjects with sarcopenia, both men and women, mean age of the sarcopenic population) and applied by two investigators to identify suitable studies. The first screening phase, performed by 2 independent reviewers, covered 455 references. Fourteen relevant studies were included in the final analysis. Overall, we noted an important heterogeneity between studies in the way of assessing sarcopenia (i.e. operational definitions, tools and cut-offs used). There were also large variations between studies in their cost analysis settings (i.e., discrepancies in time horizon, types and sources of economic data). Most of the studies focused on hospitalization costs following surgery for a specific disease such as cancer. Finally, 11 out of the 14 studies reported higher healthcare costs for sarcopenic patients. However, most of the included studies have important methodological bias (e.g. potential confusion factors rarely taken into account), and low to moderate quality scores. More standardized research, taking into account all the limitations of the published studies, should be conducted to assess the true impact of sarcopenia on healthcare consumption.

show abstract

Impact of Visceral Obesity and Sarcopenia on Short-Term Outcomes After Colorectal Cancer Surgery

Abstract: Patients with both visceral obesity and sarcopenia had a higher complication rate after colorectal cancer surgery. Age ≥ 65 years, visceral obesity, and sarcopenia were independent risk factors for total complications. Laparoscopy-assisted operation was a protective factor.

Cited by 83 publications

References 43 publications

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment

Is sarcopenia a better predictor of complications than body mass index? Sarcopenia and surgical outcomes in patients with rectal cancer

The health economics burden of sarcopenia: a systematic review

Contact Info

Product

Resources

About