Preoperative evaluation of sarcopenia in patients with colorectal cancer: a prospective study

Abstract

OBJECTIVE: Colorectal cancer is the third most diagnosed malignant neoplasm in the world and the fourth leading cause of cancer mortality. The loss of muscle mass in oncological patients is the main aspect of cancer-related malnutrition. Associations between sarcopenia and poor outcomes, such as high postoperative mortality, chemotherapy toxicity, and reduced survival, have been recently described. The aim of this study was to prospectively assess the prevalence of preoperative sarcopenia in patients with colorectal cancer using validated methods to evaluate muscle strength, muscle mass, and physical performance. METHODOLOGY: This study included patients with colorectal cancer undergoing oncological staging at a Cancer Center in Brazil from May 2019 to March 2020 who had images from abdominal computed tomography available for analysis of body composition. The muscle strength test, physical performance, referred fatigue, and clinical and nutritional data were evaluated. RESULTS: A total of 31 patients were included, and most were diagnosed with colon cancer (77.4%) and clinical stage II in 41.9% of cases. The prevalence of probable sarcopenia was 22.6%; of these patients, sarcopenia was confirmed in 19.4%, and ultimately, 9.7% of the sample was classified as severe sarcopenia. We did not find a significant association between the presence of sarcopenia in our sample and age, sex, tumor staging, nutritional characteristics, referred patient fatigue, or postoperative complications. CONCLUSION: Considering the criteria established by the EWGSOP, the prevalence of preoperative sarcopenia in colorectal cancer patients was 19.4%.

Desnutrição e Baixa Massa Muscular em Pacientes com Câncer Gastrointestinal Submetidos à Cirurgia: Existe Associação com a Localização do Tumor?

“…A avaliação da força muscular é considerada como primeiro critério para avaliação da sarcopenia, destacando sua importância 8 . Em um estudo brasileiro, foi observado que 22,6% dos pacientes com câncer colorretal apresentaram baixa força muscular 46 complicações pós-operatórias [47][48][49] . Um estudo que avalia sarcopenia em pacientes com câncer gástrico submetidos à cirurgia encontrou prevalência de baixa FPM de 32% e de sarcopenia de 68%, assim como a associação entre sarcopenia e complicações pós-operatórias e sobrevida 15 .…”

Body composition assessment with ultrasound muscle measurement: optimization through the use of semi-automated tools in colorectal cancer

“…Colorectal cancer (CRC) is a disease of high prevalence and great impact on global health, being the third most commonly diagnosed cancer worldwide and the second leading cause of cancer death ( 44 ). Abdominal CT must be routinely performed in colorectal cancer for diagnosis, staging and follow-up ( 17 , 45 , 46 ).…”

“…Sarcopenia is defined as a progressive and generalised loss of skeletal muscle mass, strength and/or physical function, which is associated with an increased risk of adverse outcomes, such as physical disability, poor quality of life, increased mortality (7) and metabolic syndrome (10)(11)(12)(13)(14). The presence of sarcopenia at diagnosis or its onset during treatment has been widely associated with poorer outcomes in terms of prognosis, higher rates of surgical complications, poorer response to chemotherapy and greater toxicity, longer hospital stay, and mortality (15)(16)(17).…”

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

“…Some studies have validated the use of CT for evaluating body composition in cancer patients, using the level of the third lumbar vertebra (L3) as a reference point [ 12 ]. Indeed, it has already been used in patients with colorectal cancer [ 13 , 14 , 15 ]. However, to our knowledge, there are no studies evaluating the predictive capacity of body composition by CT to determine low muscle mass applying both the Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition and the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria for sarcopenia.…”