Sarcopenia is an independent predictor of complications after colorectal cancer surgery

Nakanishi, Ryota; Oki, Eiji; Sasaki, Shun; Hirose, Kosuke; Jogo, Tomoko; Edahiro, Keitaro; Korehisa, Shotaro; Taniguchi, Daisuke; Kudo, Kazuhiko; Kurashige, Junji; Shimada, Masahiko; Nakashima, Yasuhiro; Ohgaki, Kippei; Saeki, Hiroshi; Maehara, Yoshihiko

doi:10.1007/s00595-017-1564-0

Cited by 134 publications

(111 citation statements)

References 27 publications

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“…No significant differences were found between sarcopenia and age. The same results were found by Nakanishi et al [19]. However, controversial results about sociodemographic data are found in the literature, and other studies report a significant association between sarcopenia and older ages [13,20].…”

Section: Discussionsupporting

confidence: 82%

“…In the literature, the results are controversial and do not always report this association. Nevertheless, in general, a higher prevalence of sarcopenia in males is known [13,19]. No significant differences were found between sarcopenia and age.…”

Section: Discussionmentioning

confidence: 92%

“…This could be explained by the different methods of diagnosis and cut-off values. These studies also used preoperative abdominal CT for the assessment of SMI, as well as the same cut-off values (Prado et al) [13,19]. Nevertheless, in the systematic review of Malietzis et al, the prevalence of sarcopenia varied from 15.9% to 71% in CRC patients, which can be explained by the heterogeneity between samples [12].…”

Section: Discussionmentioning

confidence: 99%

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Sarcopenia as a Risk Factor of Morbimortality in Colorectal Cancer Surgery

Pereira

Silva

et al. 2020

Gastrointestinal Disorders

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Background: Colorectal cancer (CRC) surgery is associated with high rates of postoperative morbimortality. Sarcopenia has been identified as an independent predictor of these surgical outcomes. Methods: A sample of 272 patients who underwent CRC surgery between January 2005 and May 2010 at Braga Hospital, was selected. Sarcopenia was defined by the skeletal muscle mass index, measured by preoperative computed tomography (CT), at L3 level, using ImageJ® software. Associations between sarcopenia and qualitative variables were analyzed by Chi-Square Test (χ2) or Fisher’s Exact Test and, for quantitative variables, by Mann-Whitney Test. A multivariate logistic regression was performed to assess if sarcopenia was an independent predictor of major morbidity. The overall and recurrence-free survivals were analyzed by Kaplan-Meier method and multivariate Cox regression was performed for recurrence-free survival. Results: The prevalence of sarcopenia was 19.1%. Sarcopenia was associated with male gender, no CRC family history and colon tumour (p < 0.001, p = 0.029 and p = 0.017, respectively). The presence of sarcopenia was associated with postoperative morbidity Clavien–Dindo classification (p = 0.003), and sarcopenia was an independent predictor for major complications (grade ≥ III) (p = 0.003). Conclusions: The evaluation of sarcopenia in patients undergoing CRC surgical resection allows to predict a higher probability of major postoperative morbimortality.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Sarcopenia as a Risk Factor of Morbimortality in Colorectal Cancer Surgery

Pereira

Silva

et al. 2020

Gastrointestinal Disorders

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“…In patients with acute and chronic illness, depleted skeletal muscle (SM) mass, also referred to as sarcopenia, is a condition associated with underlying disease processes and adverse outcomes . Imaging technologies like dual‐energy x‐ray absorptiometry and computed tomography (CT) are considered gold‐standard references for body composition assessment in research.…”

Section: Introductionmentioning

confidence: 99%

Tutorial: A Step‐by‐Step Guide (Version 2.0) for Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross‐Sectional Computed‐Tomography Image Using the National Institutes of Health ImageJ

Gomez-Perez

McKeever

Sheean

2019

J Parenter Enteral Nutr

103

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Background In patients with acute and chronic illness, depleted skeletal muscle (SM) mass, also referred to as sarcopenia, is a condition associated with an underlying disease process and adverse outcomes. Because of software upgrades and errors related to installation, clarifications and a revised tutorial were needed for calculating SM cross‐sectional area (CSA) using the National Institutes of Health (NIH) ImageJ. Methods A pilot study was conducted to determine the usability of the tutorial version 2.0. Eight adults (≥18 years of age) who had no previous experience or background in body composition or computed‐tomography imaging and owned a personal laptop computer (Mac or PC) were included in the pilot study. Participants were tested on the completion of 4 tasks: (1) installation of software, (2) updating the software, (3) following revised tutorial (version 2.0), and (4) transferring information from the software to a spreadsheet for calculation of SM CSA. Results All participants completed the tutorial and all assigned tasks, 4/4 (100%). However, 38% (3/8) of the participants made errors while cutting and pasting values from the ImageJ results box to a spreadsheet for calculating SM CSA. Conclusion The tutorial version 2.0 was easy to follow and provided sufficient information for adults to install, update, and perform the steps of body composition for the NIH ImageJ software without major issues. Care should be taken when cutting and pasting results from the software as well as when using the Microsoft Excel spreadsheet for calculating SM CSA.

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“…Sarcopenia has become an important measure in oncology patients, as it has been shown to be associated with reduced responses to therapies, poorer outcomes after surgery and decreased survival rates [7][8][9]. Although emerging evidence is conflicting, sarcopenia has been reported to be associated with increased postoperative complications and length of stay (LOS) in pelvic cancer surgery, noting these surgeries are much less complex than pelvic exenteration surgery [5,10,11].…”

Section: Introductionmentioning

confidence: 99%

Is Preoperative Sarcopenia a Good Predictor of Postoperative Complications and Outcomes after Pelvic Exenteration Surgery?

Rangan¹,

Ritorni²,

Solomon³

et al. 2020

JSO

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Background: Sarcopenia is common in oncology patients and has been found to be associated with poorer outcomes after surgery. Pelvic exenteration is a major surgery associated with high rates of morbidity. The aim of this study was to determine if preoperative sarcopenia is associated with postoperative complications and outcomes after pelvic exenteration surgery. Methods: A retrospective study was conducted including 64 oncology patients who had undergone pelvic exenteration surgery between August 2015 and January 2018 and had available preoperative lumbar CT images. Skeletal muscle index (SMI) was calculated by analysing CT images using body composition software. Sarcopenia was determined by using previously published SMI sex-specific cut-offs. Preoperative nutritional status, nutritional indicators and other clinical factors were also collected. Results: There was no association between preoperative sarcopenia and outcomes after pelvic exenteration surgery, however, increased weight (p=0.027) and BMI (p=0.025) were associated with a greater number of total complications. Increasing age was also significant (p=0.001) in explaining the greater number of complications. Greater complexity of surgery itself was associated with greater postoperative complications (p=0.014) and increased length of hospital stay (p=0.001). Conclusion: Preoperative sarcopenia, using dichotomous cut-off points, is not sensitive enough to predict postoperative complications and outcomes in oncology patients undergoing pelvic exenteration surgery; however, other preoperative factors such as weight, BMI and age, and the complexity of surgery, do affect outcomes. Assessment tools that incorporate several clinical and physical factors, such as frailty assessments, should be used in future studies to identify risk factors in such major surgeries.

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Sarcopenia is an independent predictor of complications after colorectal cancer surgery

Abstract: Sarcopenia was an independent predictive factor for postoperative complications after CRC surgery.

Cited by 134 publications

References 27 publications

Sarcopenia as a Risk Factor of Morbimortality in Colorectal Cancer Surgery

Sarcopenia as a Risk Factor of Morbimortality in Colorectal Cancer Surgery

Tutorial: A Step‐by‐Step Guide (Version 2.0) for Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross‐Sectional Computed‐Tomography Image Using the National Institutes of Health ImageJ

Is Preoperative Sarcopenia a Good Predictor of Postoperative Complications and Outcomes after Pelvic Exenteration Surgery?

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