The impact of sarcopenia on the postoperative outcome in colorectal cancer surgery

Abstract

Background and aim. Malnutrition-induced sarcopenia predicts poorer clinical outcomes for patients with cancer. Postoperative complications such as wound infection, anastomotic leak (AL), cardiorespiratory events are the most frequent and devastating postoperative complications in colorectal cancer surgery and are frequently associated with malnutrition. 
 Methods. We reviewed the recent available literature to assess the relationship between the patient nutritional status and sarcopenia in colorectal surgery. The PubMed database was searched for publications. The included studies were original articles, prospective and randomized trials, clinical, systematic reviews and meta-analyses. The information was structured in a narrative review form. 
 Results. A simple method to assess malnutrition is to define the presence of sarcopenia (skeletal muscle mass reduction and modified composition) by radiological image analysis. Quantifying the material composition and quality is a novel method in patient-specific therapy. This could be a new perspective in colorectal surgery to reduce postoperative mortality, improve surgical planning, and enhance clinical outcomes. A few recent studies have objectively investigated the presence of sarcopenia in colorectal cancer and its impact on morbidity and mortality, but sometimes the results are contradictory. 
 Conclusion. There is evolving research to find the most appropriate management method , surgeons must be aware of the existence of sarcopenia to identify this risk factor in the occurrence of postoperative complications in colorectal cancer surgery.

AI-Assisted Body Composition Assessment Using CT Imaging in Colorectal Cancer Patients: Predictive Capacity for Sarcopenia and Malnutrition Diagnosis

“…Assessing both quantitative and qualitative aspects of muscle mass in body composition evaluation introduces an innovative method in personalized patient therapy. This approach potentially offers a new perspective in colorectal surgery, aiming to reduce postoperative mortality rates, refine surgical planning, and enhance clinical outcomes [ 33 ]. In this comprehensive assessment of muscle mass, CT, which includes both quantitative and qualitative aspects, emerges as a tool superior to previous gold standards [ 34 ].…”

Enhancing Outcomes Through Preoperative Risk Evaluation in Colorectal Cancer Surgery

“…The European Society for Clinical Nutrition and Metabolism (ESPEN) de nes malnutrition to include at least one of the following criteria: a weight loss of more than 10% of the original weight within six months, a BMI lower than 18.5 kg/m 2 , serum albumin less than 35 g/L, in the absence of liver or kidney dysfunction [135,136,137,138,139,140]. Fujimichi et al reported that malnutrition is an independent risk factor for postoperative incision infection in colorectal cancer patients (OR = 2.52, 95%, p = 0.01) [42,141,142]. Furthermore, a registry study at the Hokeland University Hospital in Norway showed that among 1194 patients undergoing surgical treatment, those at nutritional risk were more likely to develop incision infections, with a positive correlation between the incidence of incision infections and nutritional risk (OR = 1.81, p = 0.047) [143,144,145,146].…”

Our Experience With Left Colon and Rectal Cancer Surgery and the Impact of Preoperative Sarcopenia on Complication Rates

“…In patients who underwent surgery for colorectal cancer, sarcopenia increased the risk of postoperative complications and negatively impacted survival [ 2 ]. Evaluation of sarcopenia in the perioperative period and closer monitoring of the patients who are at risk will enable early detection of complications, especially anastomotic leaks [ 3 ].…”