Sarcopenia is associated with increased severe postoperative complications after colon cancer surgery

Abstract

Introduction: Studies have shown that sarcopenia is associated with poor outcomes in patients with gastrointestinal cancer undergoing surgery. We aimed to investigate the relationship between postoperative complications of sarcopenic patients who had been operated on for colon cancer and the effects on short-term mortality. Material and methods: In this study, patients who had undergone colon cancer surgery between January 2013 and December 2018 were collected retrospectively. Sarcopenia was diagnosed by the skeletal muscle index (SMI) derived from a preoperative computed tomography scan. Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with postoperative major complications (POMC). Results: The study included 160 patients with a mean age of 62.4 ±12.6 years. Clavien-Dindo grade 1-2 (minor) complications were not significantly different between the groups (p = 0.896). However, grade ≥ 3 (major) complications were detected in 13 (17.8%) patients in the sarcopenic group (SG) and in 5 patients in the non-sarcopenic group (NSG) (5.7%) (p = 0.016). Length of intensive care unit (ICU) stay was longer in SG (p = 0.002) and there was no difference between 1-month and 6-month mortality rates (p = 0.273 and p = 0.402, respectively). According to univariate analyses, sarcopenia and age over 65 years were related to POMC. In multivariate analyses, sarcopenia (odds ratio = 3.039; 95% confidence interval 1.008-9.174; p = 0.048) and advanced age (odds ratio = 3.246; 95% confidence interval 1.078-9.803; p = 0.036) were found to be independent risk factors for POMC. Conclusions: This study showed that while sarcopenia is a risk factor for POMC, sarcopenia also prolongs the duration of ICU stay. Also sarcopenia has no effect on short-term mortality.

Age as a modifier of the effects of sarcopenia on survival among colon cancer patients after surgery

“…A number of studies have been conducted to evaluate the effects of sarcopenia on the survival of colon cancer patients after surgery, but the findings have been inconsistent. Some studies found that sarcopenia was a predictor for worse OS, 29–38 but some others found that sarcopenia was not associated with OS 39–41 . Discrepancies in the prognostic contributions of sarcopenia might be in part due to differences in the methods used to determine sarcopenia.…”

Preoperative evaluation of sarcopenia in patients with colorectal cancer: a prospective study

“…Associations between sarcopenia and worse prognosis, such as high postoperative mortality, chemotherapy toxicity, reduced survival, higher infection rates, increased hospital length of stay, and increased mortality, have been pointed out recently [6][7][8][9][10][11][12][13] . Surgical resection in a patient with nonmetastatic colorectal cancer is an important aspect of cancer management, and including the evaluation of sarcopenia as a predictor of perioperative or postoperative morbidity risk can provide prognostic information for surgeons and patients.…”

Fat-free Muscle Index Predicts Overall Survival in Mass-forming Intrahepatic Cholangiocarcinoma Patients: A Sex-stratified Analysis

“…In addition, the patient's conditions such as skeletal muscle status and fat distribution may influence prognosis after surgery [7,8] . Sarcopenia, defined as the loss of skeletal muscle mass and strength [9] , is currently a hot research topic due to its high prevalence and association with adverse outcomes in patients with various malignancies [7,8,10,11] . The cross-sectional images of computerized tomography (CT) and magnetic resonance imaging (MRI) are now considered standards for muscle mass evaluation [12] .…”