Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis

Trejo-Ávila, Mario; Bozada‐Gutiérrez, Katya; Valenzuela-Salazar, Carlos; Herrera-Esquivel, J.J.; Moreno-Portillo, Mucio

doi:10.1007/s00384-021-03839-4

Cited by 134 publications

(115 citation statements)

References 86 publications

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“…Recent studies have focused on patients with sarcopenia diagnosed using various methods. According to a recently published meta-analysis, sarcopenia is associated with poor postoperative outcomes and decreased survival rates in colorectal cancer patients [12]. Supporting the meta-analysis, our study established a higher rate of postoperative complications and a longer hospital stay in patients with a SARC-F score ≥ 4.…”

Section: Discussionsupporting

confidence: 82%

Interpretation of the SARC-F questionnaire in patients undergoing gastrointestinal cancer surgery

et al. 2021

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Sarcopenia is a skeletal muscle disorder associated with decreased muscle mass and functional capacity. The SARC-F questionnaire facilitates sarcopenia screening in elderly patients. The present study investigates the applicability of the SARC-F questionnaire to sarcopenia screening in patients scheduled for gastrointestinal cancer surgery and its relationship with postoperative outcomes.Material and methods: This cross-sectional study was carried out with elderly patients scheduled for gastrointestinal cancer surgery. The study included 71 patients consisting of 47 males and 24 females. The risk of sarcopenia was assessed by the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falling (SARC-F) questionnaire. Patients with a SARC-F score ≥4 were considered to be at risk of sarcopenia. The demographic data, nutritional status and comorbidity data of the patients were recorded. Statistical analysis was conducted to assess postoperative complications in those patients at risk of sarcopenia.Results: The mean age of 71 study patients was 72.6±5.6 years. There were 15 (21.1%) patients with a SARC-F score ≥4. The postoperative complication rate was 60% in patients with a SARC-F score ≥4 in comparison with 28.5% of those with a SARC-F score <4, and the difference was statistically significant (p=0.024). The SARC-F score ≥4 group also had a longer hospital stay (p<0.001). Furthermore, the univariate analysis for postoperative complications revealed that SARC-F scores ≥4, age ≥75 years, and BMI ≥30 kg/m2 were statistically significant. Conclusion:We believe that the SARC-F questionnaire has a place in sarcopenia screening in patients scheduled for gastrointestinal surgery, and it is possible to predict postoperative adverse outcomes.

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Section: Discussionsupporting

confidence: 82%

Interpretation of the SARC-F questionnaire in patients undergoing gastrointestinal cancer surgery

et al. 2021

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“…Moreover, recent meta-analyses have revealed that sarcopenia is a mortality risk in people with colorectal cancer (25). In addition to these meta-analyses, recent studies have confirmed that sarcopenia is a risk factor for morality in people on hemodialysis (5) and in older hospitalized people (12).…”

Section: Discussionmentioning

confidence: 88%

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

et al. 2021

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BackgroundSarcopenia has reportedly been associated with increased risk of mortality in general populations. However, few studies have investigated the association between sarcopenia and mortality in older people with type 2 diabetes mellitus (T2D). This study aimed to investigate the effect of sarcopenia on incident all-cause mortality in older people with T2D.MethodsLow muscle strength were set at handgrip strength <28 kg for men and <18 kg for women, and low skeletal muscle mass index (SMI), evaluated using the impedance body composition analyzer, were set at SMI <7.0 kg/m2 for men and <5.7 kg/m2 for women. People who had both low muscle strength and low SMI were diagnosed with sarcopenia. Due to a low incidence of all-cause mortality, the propensity score was used. The propensity score was evaluated using multivariable logistic regression models with the following parameters: age, sex, duration of diabetes, history of heart disease, history of cancer, smoking, exercise, alcohol, sodium-glucose cotransporter-2 inhibitor, glucagon-like peptide-1 receptor agonist, insulin, corticosteroid, hypertension, body mass index, glycosylated hemoglobin A1c, triglycerides, and creatinine, and the C-statistic was 0.89.ResultsIn this prospective cohort study, 396 people with an average age and duration of diabetes of 71.3 (6.3) years and 16.3 (11.3) years, respectively, were included. Of those included, 14.6% had sarcopenia. During the average 40.5 (16.5) months of follow-up, 13 people (6 out of the 338 without sarcopenia and 7 out of the 58 with sarcopenia) died. Incident rate were 5.1/1000 person years of follow-up in people without sarcopenia and 41.3/1000 person years of follow-up in people with sarcopenia. According to Cox regression analysis, sarcopenia was associated with all-cause mortality (adjusted hazard ratio: 6.12, 95% confidence interval: 1.52–24.7, p = 0.011).ConclusionSarcopenia is associated with incident all-cause mortality in older outpatients with T2D.

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“…However, many patient-dependent factors, such as malnutrition, sarcopenia, or a deterioration in general status, have been associated with poorer perioperative outcomes and a delay in the start of adjuvant chemotherapy, with globally worse oncological outcomes being obtained [7][8][9][10]. Adequate nutritional status with preservation of lean mass (LM) has become an important objective to be considered in the perioperative period of patients with CRC [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic

López-Rodríguez-Arias

Sánchez‐Guillén

Ostáriz

et al. 2021

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Background Surgery remains the first curative treatment for colorectal cancer. Prehabilitation seems to attenuate the loss of lean mass in the early postoperative period. However, its long-term role has not been studied. Lockdown due to the COVID-19 pandemic has forced to carry out the prehabilitation program at home. This study aimed to assess the effect of home prehabilitation on body composition, complications, and hospital stay in patients undergoing oncological colorectal surgery. Methods A prospective and randomized clinical study was conducted in 20 patients operated of colorectal cancer during COVID-19 lockdown (13 March to 21 June 2020) in a single university clinical hospital. Patients were randomized into two study groups (10 per group): prehabilitation vs standard care. Changes in lean mass and fat mass at 45 and 90 days after surgery were measured using multifrequency bioelectrical impedance analysis. Results Prehabilitation managed to reduce hospital stay (4.8 vs 7.2 days, p = 0.052) and postoperative complications (20% vs 50%, p = 0.16). Forty-five days after surgery, the loss of lean mass decreased (1.7% vs 7.1%, p = 0.17). These differences in lean mass were attenuated at 90 days; however, the standard care group increased considerably their fat mass compared to the prehabilitation group (+ 8.72% vs − 8.16%). Conclusions Home prehabilitation has proven its effectiveness, achieving an attenuation of lean mass loss in the early postoperative period and a lower gain in fat mass in the late postoperative period. In addition, it has managed to reduce hospital stays and postoperative complications. Registration number This article is part of an ongoing, randomized, and controlled clinical trial approved by the ethics committee of our hospital and registered in ClinicalTrials.gov in August 2018 with registration number NCT03618329.

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Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis

Cited by 134 publications

References 86 publications

Interpretation of the SARC-F questionnaire in patients undergoing gastrointestinal cancer surgery

Interpretation of the SARC-F questionnaire in patients undergoing gastrointestinal cancer surgery

Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

Effect of home-based prehabilitation in an enhanced recovery after surgery program for patients undergoing colorectal cancer surgery during the COVID-19 pandemic

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