Clinical impact of sarcopenia in patients with colon cancer undergoing laparoscopic surgery

Abstract

Previous studies have reported that progressive muscle loss, known as sarcopenia, has a negative impact on colon cancer treatment. However, the majority of studies have analyzed on patients undergoing open resection, and the association of sarcopenia with clinical outcomes is not clear for patients with colon cancer undergoing laparoscopic surgery. Thus, the aim of this study was to evaluate the impact of sarcopenia on clinical outcomes after laparoscopic surgery for colon cancer. Methods: A total of 423 patients who underwent laparoscopic surgery for colon cancer between November 2010 and October 2014 were included. Body composition was assessed by measuring muscle and fat areas at the third lumbar vertebra (L3) on preoperative computed tomography. The L3 skeletal muscle area was used to calculate the skeletal muscle index and to assess for sarcopenia. Results: Sarcopenia was identified in 54 patients (12.8%). The median time to first flatus (3 days), median time to tolerable soft diet (4 days), and median length of hospital stay (7 days) were not significantly different between patients with and without sarcopenia. However, sarcopenia was an independent risk factor for postoperative complications in the logistic regression multivariate analysis (P = 0.015). Sarcopenia was not associated with overall or disease-free survival. Conclusion: Sarcopenia was not negatively associated with functional recovery, hospital stay, and oncologic outcomes in patients with colon cancer who underwent laparoscopic surgery. However, sarcopenia was associated with postoperative complications after laparoscopic surgery for colon cancer.

The Clinical Impact of Combining Neutrophil-to-Lymphocyte Ratio with Sarcopenia for Improved Discrimination of Progression-Free Survival in Patients with Colorectal Cancer

“…On the other hand, there are still shortcomings in applying the previous pivotal definitions of sarcopenia to clinical use. Many studies have shown no difference in survival according to the criteria of sarcopenia defined by Martin et al and/or Prado et al [12][13][14]19,22]. It is difficult to explain, in brief, why the clinical significance of sarcopenia differs in each study.…”

“…In addition, low skeletal muscle index (SMI), a key feature of sarcopenia, has been known to be associated with poor oncologic outcomes, even in patients with CRC [5,10,11]. However, despite being validated by various studies and most other studies adopting cut-off values derived from previous pivotal studies, a number of studies have shown that sarcopenia is not related to survival in patients with CRC [12][13][14]. The reason for this discordance across studies has not been clearly proven; however, differences in body composition, including muscle mass, across different ethnicities might be one possible reason [15].…”

Impact of Sarcopenia on Postoperative Complications in Obstructive Colorectal Cancer Patients Who Received Stenting as a Bridge to Curative Surgery

“…Increased postoperative complications and decreased treatment tolerability to chemotherapy could be possible explanations [5,6]. However, two studies involving more than 400 CRC patients failed to demonstrate significant differences in OS and RFS between sarcopenic and non-sarcopenic patients [42,43]. Regarding the OCRC, CT-based myopenia was significantly associated with obstruction [16].…”

Impact of Body Composition on Postoperative Outcomes in Patients Undergoing Robotic Nipple-Sparing Mastectomy with Immediate Breast Reconstruction

“…The SMM, as well as subcutaneous, visceral, and total adipose tissue areas, were measured by a radiologist at the 3rd lumbar vertebra (L3) level of a transverse, cross-sectional CT image obtained during preoperative staging workup [ 24 ]. Total cross-sectional areas were measured by applying Hounsfield unit thresholds of −29 to +150 for skeletal muscle, −190 to −30 for subcutaneous adipose tissue, and −50 to −150 for visceral adipose tissue, using a commercially available imaging software (Aquarius Intuition version 4.4.12, TeraRecon Inc., San Mateo, CA, USA) [ 25 , 26 ]. The measured areas (cm 2 ) were normalized for height (m 2 ) and were defined as the skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), and total adipose tissue index (TATI).…”