Aerobic fitness and muscle density play a vital role in postoperative complications in colorectal cancer surgery

Abstract

Background and Objectives To assess the association of preoperative aerobic fitness and body composition variables with a patient's resilience to the development and impact of postoperative complications after elective colorectal cancer (CRC) surgery. Methods Preoperative aerobic fitness was assessed by steep ramp test performance. Preoperative body composition was assessed by muscle mass and density determined from preoperative computed tomography scan analysis at the L3‐level. Complication development and severity was graded according to Clavien‐Dindo. Complication impact was assessed by the time to recovery of physical functioning after complications. Multivariable logistic regression analyses adjusted for age, sex, comorbidities and tumour location was performed. Results Of 238 included patients, 96 (40.3%) developed postoperative complications. Better preoperative aerobic fitness decreased the likelihood to develop complications, independent of muscle mass (odds ratio [OR]: 0.55, 95% confidence interval [CI]: 0.35−0.85) or muscle density (OR: 0.57, 95% CI: 0.36−0.89). A prolonged time to recovery following complications was associated with lower preoperative muscle density (OR: 4.14, 95% CI: 1.28−13.41), independent of aerobic fitness. Conclusions Lower aerobic fitness increases the risk of complication development, while low muscle density seems associated with a prolonged recovery from complications. Aerobic fitness and muscle density could be valuable additives to preoperative risk assessment.

The psoas muscle density as a predictor of postoperative complications in elderly patients undergoing rectal cancer resection

“…Benedek et al [11] discovered that TPA was related to postoperative complications instead of PMD, consistent with Wu et al [9]. However, Pekařová et al [12] and Cuijpers et al [13] unveiled that PMD was correlated with postoperative complications rather than TPA. Although the indicators of sarcopenia are controversial, the number of cases in our study can tackle this di culty.…”

Use of 3D-CT-derived psoas major muscle volume in defining sarcopenia in colorectal cancer

“…In recent years, there have been reports not only on the volume and the area of skeletal muscle but also on the skeletal muscle density, with individuals having low skeletal muscle density often referred to as having myosteatosis [36][37][38][39][40]. Moreover, muscle density can also be measured using CT, similar to PA and PV.…”

Steep ramp test protocol for preoperative risk assessment and short‐term high‐intensity interval training to evaluate, improve, and monitor cardiorespiratory fitness in surgical oncology

“…The SRT WR peak is equal to 148% of the CPET WR peak , while the peripheral muscle strength is the predominant limitation of SRT performance. Previous studies reported that preoperative SRT (1 W/s) performance (WR peak , W/kg) is inversely associated with the risk of adverse postoperative outcomes after hepatic, 18 pancreatic, 19 and colorectal resection 20,21 . However, a test‐specific cutoff and multivariate predictive model including the SRT performance that can be used to classify patients at low versus high risk for adverse surgical outcomes are lacking; therefore, further research is required.…”