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Techniques in Coloproctology

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Open Access 01-09-2019 | Computed Tomography | Original Article

The relationship between sarcopenia and survival at 1 year in patients having elective colorectal cancer surgery

Authors: D. R. Dolan, K. A. Knight, S. Maguire, S. J. Moug

Published in: Techniques in Coloproctology | Issue 9/2019

Abstract

Background

Colorectal cancer remains a common cause of cancer death in the UK, with surgery being the mainstay of treatment. An objective measurement of the suitability of each patient for surgery, and their risk–benefit calculation, would be of great utility. We postulate that sarcopenia (low muscle mass) could fulfil this role as a prognostic indicator. The aim of this study was to determine the relationship between sarcopenia and long-term outcomes in patients undergoing elective bowel resection for colorectal cancer.

Methods

One hundred and sixty-three consecutive patients who had elective curative colorectal resection for cancer were eligible for inclusion in the study. Psoas muscle mass was assessed on preoperative computed tomography scan at the level of the L3 vertebra and standardised for patient height (total psoas index, TPI). Sarcopenia (low muscle mass) was defined as < 524 mm²/m² in males and 385 mm²/m² in females. In addition to clinical–pathological parameters, postoperative complications were recorded and patients were followed up for mortality for 1 year after surgery.

Results

Sarcopenia was present in 19.6% of the study participants and was significantly related to body mass index (p = 0.007), 30-day mortality (p = 0.042) and 1-year mortality (p = 0.046). In univariate analysis, American Society of Anesthesiologists grade (p = 0.016), tumour stage (p = 0.018) and sarcopenia (p = 0.043) were found to be significant independent predictors of 1-year mortality.

Conclusions

This study has found sarcopenia to be prevalent in patients with colorectal cancer having elective surgery. Independent of age, sarcopenia was associated with poorer 30-day mortality and survival at 1 year. Measurement of muscle mass preoperatively could be used to stratify a patient’s risk, allowing targeted strategies such as prehabilitation, to be implemented to modify sarcopenia and improve long-term outcomes for patients.

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Title: The relationship between sarcopenia and survival at 1 year in patients having elective colorectal cancer surgery
Authors: D. R. Dolan
K. A. Knight
S. Maguire
S. J. Moug
Publication date: 01-09-2019
Publisher: Springer International Publishing
Keywords: Computed Tomography
Sarcopenia
Computed Tomography
Colorectal Cancer
Colorectal Cancer
Published in: Techniques in Coloproctology / Issue 9/2019
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-019-02072-0

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The relationship between sarcopenia and survival at 1 year in patients having elective colorectal cancer surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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