Clinical Impact of Sarcopenia on Gastrointestinal Tumors

Abstract

Preoperative risk stratification in cancer surgery is important to improve treatment and outcome. Sarcopenia is defined by progressive and generalized loss of skeletal muscle mass and strength and is now getting attention as a poor prognostic factor. The purpose of this review was to explore the impact of sarcopenia on short and long-term outcomes in patients undergoing surgical resection of gastrointestinal tumors. Recent studies suggest that sarcopenia contributes to postoperative complications and overall survival. The relatively simple evaluability, as well as its modifiable nature, provides an intriguing potential for sarcopenia to be included in standard preoperative clinical evaluation. Such evaluations can provide physicians with important information to target high-risk individuals with prophylactic measures and eventually improve surgical outcomes.

Age as a modifier of the effects of sarcopenia on survival among colon cancer patients after surgery

“…We also found that preoperative sarcopenia was associated with a hospital stay of 5.7 days longer, and this is consistent with the finding of 6 days longer in a study by Richards et al 41 Preoperative risk stratification is of extreme importance in patient selection for surgery, as it may help physicians to recognize patients with a high risk of worse outcome after the procedure 42 …”

“…The dual risk may explain our observation that age acted as a modifier of the effects of sarcopenia on survival in colon cancer patients 43 . Such evaluations can provide physicians with important information to target high‐risk individuals with prophylactic measures and eventually improve surgical outcomes 42 . Although the sample size of our study was not very large, it has provided enough power to detect the effect modification, which indicates that the effect modification is substantial.…”

“…We also found that preoperative sarcopenia was associated with a hospital stay of 5.7 days longer, and this is consistent with the finding of 6 days longer in a study by Richards et al 41 Preoperative risk stratification is of extreme importance in patient selection for surgery, as it may help physicians to recognize patients with a high risk of worse outcome after the procedure. 42 CT scans represent a convenient method for the evaluation of body composition, as a practical, low-cost method that can contribute to a better understanding of the disease and identify strategies for improving the clinical and nutritional performance of the patient. 15 The present study showed that sarcopenia defined by a low SMI measured using CT scan at the L3 level could serve as an indicator of poor prognosis in patients with colon cancer.…”

Sarcopenia: the ‘hidden’ marker of surgical outcome

“…2 It can occur in normal weight or overweight patients, distinguishing it from weight loss or cachexia. 3 It has been reported that the prevalence of sarcopenia is 10% in the general population, 4 but the mean incidence increases to 34.7% (range from 2.1 to 83.3%) in gastrointestinal cancer patients. 5 The clinical importance with sarcopenia is the association with poor short-and long-term outcomes.…”

“…Importantly, the latest consensus by the European Working Group on Sarcopenia (EWGSOP2) uses low muscle strength as the primary parameter of sarcopenia 2 . It can occur in normal weight or overweight patients, distinguishing it from weight loss or cachexia 3 …”