Sarcopenia As a Determinant Prognostic Factor After Surgery Among Patients with Colorectal Cancer.

Abstract

Introduction: Surgery for colorectal cancer (CRC) is not risk-free; therefore, preoperative evaluation must be done to predict and prevent surgical complications. Sarcopenia, a loss of muscle mass and function, was shown to be associated with surgical complications. Our study evaluates the effects of sarcopenia on short-term patient outcomes after CRC resection.

Materials and methods: Our retrospective study included patients with histologically proven CRC between 2018 and 2020 who underwent surgical resection. Skeletal muscle mass (cm2) was evaluated on a preoperative CT scan at the level of L3 vertebrae then standardized using stature (m2) to obtain the skeletal mass index (SMI) (cm2/m2). Patients received proper adjuvant care if needed and were followed up 90 days post surgery. Descriptive statistics were presented in percentage for categorical variables and in mean for continuous variables. Multivariate was made by linear regression.

Results: 113 patients were included, and 15% were sarcopenic. A statistically non-significant association was found between sarcopenia and severe complications (grade III-IV) (23.53% in sarcopenic vs. 9.38% non-sarcopenic, p=0.02, multivariate p=0.675). Sarcopenia was not associated with anastomotic leakage, infectious complications, or ileus or intra-abdominal bleeding (p>0.05). In literature, some studies showed an association between sarcopenia and postoperative complications while others showed no relationship between the two. Most studies used SMI.

Conclusion: A non-statistically significant association was found between sarcopenia and postoperative complications in CRC patients. Sarcopenia does not predict postoperative severe complications, anastomotic leakage, infectious complications, or ileus or intra-abdominal bleeding. Emergent surgeries and age >60 years were associated with more postoperative complications.