Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer

Boer, B.C.J. de; Graaff, Feike de; Brusse-Keizer, Marjolein; Bouman, D.E.; Slump, C. H.; Slee-Valentijn, Monique S.; Klaase, Joost M.

doi:10.1007/s00384-016-2538-1

Cited by 106 publications

(100 citation statements)

References 31 publications

(50 reference statements)

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“…It was concluded that low muscle density is associated with major postoperative complications in older patients who undergo surgery for colorectal cancer. Moreover, Boer et al investigated the role of low skeletal muscle mass (sarcopenia) as prognostic factor for postoperative complications and survival in 91 patients with resectable colon cancer (23). In that study, skeletal muscle mass was measured as total psoas area and total abdominal muscle area at three anatomical levels on the preoperative CT scan.…”

Section: Discussionmentioning

confidence: 99%

Preoperative evaluation of skeletal muscle mass in the risk assessment for the short‑term outcome of elderly colorectal cancer patients undergoing colectomy

et al. 2018

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Abstract. The prevalence of colorectal cancer in the elderly population is increasing; therefore, surgical interventions with a risk of potential complications are more frequently performed. The aim of the present study was to elucidate whether sarcopenia has a clinical impact on short-term outcomes, such as morbidity and hospital stay after surgery, in elderly patients with colorectal cancer. A total of 82 elderly patients undergoing colectomy for colorectal cancer between January 2011 and December 2015 in our institute were included in the study, and skeletal muscle mass was measured as total psoas area at the level of the third lumbar vertebra (L3) using enhanced computed tomography scans. The patients were divided into two subgroups, namely those with and those without sarcopenia, based on median skeletal muscle mass in men and women, and the association with complications was analyzed. A total of 40 patients (48.8%) were diagnosed with sarcopenia. The patients with sarcopenia exhibited a significantly higher incidence of total complications (55 vs. 31.0%, P=0.028) and longer hospital stay (25.9±21.2 vs. 18.2±8.5 days, P=0.039). The multivariate logistic analysis revealed that sarcopenia was an independent risk factor for postoperative surgical complications. The short-term outcomes, such as postoperative surgical complications and hospital stay, were affected by preoperative sarcopenia in elderly colorectal cancer patients. To improve the short-term outcomes of such patients, it is necessary to carefully plan the surgical procedure, perioperative care and the surgical strategy using preoperative sarcopenia assessment.

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Section: Discussionmentioning

confidence: 99%

Preoperative evaluation of skeletal muscle mass in the risk assessment for the short‑term outcome of elderly colorectal cancer patients undergoing colectomy

et al. 2018

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“…The few studies that have been able to directly measure body composition have demonstrated that low muscle mass (10–16) or higher visceral adiposity (17–23) are associated with worse survival. Most of these studies, however, have been very small (n<250) and conducted in advanced cancer patients with poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study)

Caan

Meyerhardt

Kroenke

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

279

283

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Background Body composition may partially explain the U-shaped association between BMI and colorectal cancer (CRC) survival. Methods Muscle and adiposity at CRC diagnosis and survival were examined in a retrospective cohort using Kaplan Meier curves, multivariable Cox regression, and restricted cubic splines in 3,262 early stage (I-III) male (50%) and female (50%) patients. Sarcopenia was defined using optimal stratification and sex- and BMI-specific cut points. High adiposity was defined as the highest tertile of sex-specific total adipose tissue (TAT). Primary outcomes were overall mortality (OM) and CRC specific mortality (CRCsM). Results Forty-two percent of patients were sarcopenic. During 6.0 years of follow-up, 788 deaths occurred, including 433 from CRC. Sarcopenic patients had a 27% (HR 1.27; 95% CI 1.09, 1.48) higher risk of OM, than those who were not sarcopenic. Females with both low muscle and high adiposity had a 64% higher risk of OM (HR 1.64; 95% CI 1.05, 2.57) when compared to females with adequate muscle and lower adiposity. The lowest risk of OM was seen in patients with a BMI between 25-<30-kg/m2, a range associated with the greatest number of patients (58.6%) who were not at increased risk of OM due to either low muscle or high adiposity. Conclusions Sarcopenia is prevalent among non-metastatic CRC patients, and should, along with adiposity be a standard oncological marker. Impact Our findings suggest a biological explanation for the obesity paradox in CRC and refute the notion that the association between overweight and lower mortality is due solely to methodological biases.

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“…In a recent study published in this journal, Boer et al [1] reported that skeletal muscle quality was a predictor of overall complications after open colon resection for cancer, whereas sarcopenic obesity was a predictor of severe complications. In addition, sarcopenia was a negative predictor of overall survival.…”

Section: Dear Editormentioning

confidence: 97%

The relevance of muscle mass and quality to postoperative complications after open colon resection

Ueshima

Wakabayashi

Maeda³

et al. 2016

Int J Colorectal Dis

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Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer

Abstract: Skeletal muscle quality is a predictor for overall complications, whereas sarcopenic obesity is a predictor for severe postoperative complications after open colon resection for cancer. Sarcopenia on itself is a predictor for worse overall survival.

Cited by 106 publications

References 31 publications

Preoperative evaluation of skeletal muscle mass in the risk assessment for the short‑term outcome of elderly colorectal cancer patients undergoing colectomy

Preoperative evaluation of skeletal muscle mass in the risk assessment for the short‑term outcome of elderly colorectal cancer patients undergoing colectomy

Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study)

The relevance of muscle mass and quality to postoperative complications after open colon resection

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