Sarcopenia does not affect treatment outcomes in patients with rectal cancer undergoing laparoscopic surgery

Abstract

Purpose: Previous studies have reported that sarcopenia negatively impacts rectal cancer treatment. However, most published studies have analyzed only patients undergoing open surgery, and the association between sarcopenia and clinical outcomes in patients with rectal cancer undergoing laparoscopic surgery remains unclear. This study aimed to evaluate the effect of sarcopenia on the clinical and oncological outcomes of laparoscopic rectal cancer surgery.Methods: Three hundred and one patients undergoing laparoscopic rectal cancer surgery were enrolled between December 2009 and May 2016. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate sarcopenia.Results: Sarcopenia was identified in 72/301 (23.9%) patients. Patients with sarcopenia had decreased skeletal muscle area (P < 0.001). However, there were no significant differences in visceral fat, subcutaneous fat, and body mass index. The time to tolerable soft diet and length of hospital stay were shorter in sarcopenia patients. The time to first flatus, postoperative complications, and overall and disease-free survival rates were not significantly different between those with and without sarcopenia. High American Society of Anesthesiologist classification (≥3; P = 0.014) and abdominoperineal resection (P = 0.003) were identified as risk factors for postoperative complications.Conclusion: Sarcopenia does not negatively affect the functional recovery, postoperative complications, or survival after laparoscopic rectal cancer surgery. Further studies are necessary to validate that laparoscopic surgery could eliminate the negative impact of sarcopenia in patients with rectal cancer.