Preoperative sarcopenia negatively impacts short‐ and long‐term outcomes of rectal cancer: A propensity score‐matched analysis

Abstract

AimSarcopenia is associated with poor postoperative outcomes in various cancers; however, limited evidence is available for rectal cancer. Therefore, the present study examined the effects of skeletal muscle mass on the short‐ and long‐term outcomes of rectal cancer.Materials and MethodsA total of 787 Stage I–IV rectal cancer patients who underwent curative resection between 2003 and 2021 at The University of Tokyo Hospital were included. We conducted a propensity score‐matched analysis to mitigate confounding bias. The third lumber psoas muscle mass was measured to define sarcopenia.ResultsAmong 787 patients, 350 (44.5%) were classified as having sarcopenia. After matching, 532 patients were analyzed. Patient characteristics in the sarcopenia and nonsarcopenia groups were similar; however, the body mass index differed. The sarcopenia group had significantly higher rates of postoperative complications of all grades (33.1% vs 24.8%; p = 0.035), of grade ≥2 (29.3% vs 21.8%; p = 0.047), and anastomotic leakage (1.9% vs 0%; p = 0.0082) than the nonsarcopenia group. The 5‐y overall survival rate was significantly lower in the sarcopenia group than in the nonsarcopenia group (85.3% vs 91.8%, p = 0.019). Disease‐free survival was similar between the groups (p = 0.40). In the total cohort analysis, sarcopenia was an independent risk factor for total postoperative complications (odds ratio 1.41, p = 0.042).ConclusionPreoperative sarcopenia is associated with more total postoperative complications, more anastomotic leakage, and worse survival in rectal cancer patients.