Preoperative Prediction of Sarcopenia in Patients Scheduled for Gastric and Colorectal Cancer Surgery.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-03-21 DOI:10.1007/s12029-025-01206-y

Beijia Zhou, Yanjun Song, Chen Chen, Xiaotian Chen, Tingting Tao

{"title":"Preoperative Prediction of Sarcopenia in Patients Scheduled for Gastric and Colorectal Cancer Surgery.","authors":"Beijia Zhou, Yanjun Song, Chen Chen, Xiaotian Chen, Tingting Tao","doi":"10.1007/s12029-025-01206-y","DOIUrl":null,"url":null,"abstract":"Introduction: Sarcopenia negatively impacts surgical outcomes in gastrointestinal cancer patients, yet practical preoperative screening tools are lacking. The CRP/ALB ratio, a novel biomarker of systemic inflammation and nutritional status, may enhance sarcopenia prediction but remains underexplored in surgical oncology. This study aims to identify the predictors for preoperative sarcopenia prediction in gastric and colorectal cancer patients.Methods: This retrospective study analyzed 145 patients undergoing curative surgery (2019-2021). Sarcopenia was defined by sex-specific CT-measured L3 skeletal muscle index (cutoffs, male ≤ 40.8 cm2/m2; female ≤ 34.9 cm2/m2). Multivariable logistic regression identified predictors, with model performance assessed via ROC analysis and Cohen's Kappa.Results: The cohort (median age 64 years; 73.8% male) comprised 66 gastric (45.5%) and 79 colorectal (54.5%) cancer patients, with 29 (20%) diagnosed with sarcopenia. Sarcopenic patients exhibited a higher NRS 2002 score (P < 0.001), lower PNI score (P < 0.05), and higher CRP/ALB ratio (P < 0.05). Multivariate logistic regression analysis results showed that CRP/ALB ratio (OR = 3.084, 95% CI 1.071-8.882, P = 0.037), age (OR = 1.074, 95% CI 1.021-1.130, P = 0.006), and BMI (OR = 0.667, 95% CI 0.542-0.820, P = 0.000) were associated with the increased risk of sarcopenia. The combined model achieved superior discrimination (AUC = 0.854, 95% CI 0.770-0.937), yielding 75.86% sensitivity and 84.82% specificity at optimal cutoff value - 1.0340, and a Cohen's Kappa coefficient of 0.542 when compared to CT results.Conclusion: The CRP/ALB ratio combined with BMI and age is utilized as a convenient and effective tool for preoperative sarcopenia screening. This model-driven approach provides robust strategies to facilitate preoperative interventions, optimize perioperative care, and enhance long-term oncological outcomes for patients undergoing gastric and colorectal cancer surgery.","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"82"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01206-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Sarcopenia negatively impacts surgical outcomes in gastrointestinal cancer patients, yet practical preoperative screening tools are lacking. The CRP/ALB ratio, a novel biomarker of systemic inflammation and nutritional status, may enhance sarcopenia prediction but remains underexplored in surgical oncology. This study aims to identify the predictors for preoperative sarcopenia prediction in gastric and colorectal cancer patients.

Methods: This retrospective study analyzed 145 patients undergoing curative surgery (2019-2021). Sarcopenia was defined by sex-specific CT-measured L3 skeletal muscle index (cutoffs, male ≤ 40.8 cm²/m²; female ≤ 34.9 cm²/m²). Multivariable logistic regression identified predictors, with model performance assessed via ROC analysis and Cohen's Kappa.

Results: The cohort (median age 64 years; 73.8% male) comprised 66 gastric (45.5%) and 79 colorectal (54.5%) cancer patients, with 29 (20%) diagnosed with sarcopenia. Sarcopenic patients exhibited a higher NRS 2002 score (P < 0.001), lower PNI score (P < 0.05), and higher CRP/ALB ratio (P < 0.05). Multivariate logistic regression analysis results showed that CRP/ALB ratio (OR = 3.084, 95% CI 1.071-8.882, P = 0.037), age (OR = 1.074, 95% CI 1.021-1.130, P = 0.006), and BMI (OR = 0.667, 95% CI 0.542-0.820, P = 0.000) were associated with the increased risk of sarcopenia. The combined model achieved superior discrimination (AUC = 0.854, 95% CI 0.770-0.937), yielding 75.86% sensitivity and 84.82% specificity at optimal cutoff value - 1.0340, and a Cohen's Kappa coefficient of 0.542 when compared to CT results.

Conclusion: The CRP/ALB ratio combined with BMI and age is utilized as a convenient and effective tool for preoperative sarcopenia screening. This model-driven approach provides robust strategies to facilitate preoperative interventions, optimize perioperative care, and enhance long-term oncological outcomes for patients undergoing gastric and colorectal cancer surgery.

查看原文本刊更多论文

胃、结直肠癌手术患者肌肉减少症的术前预测

前言：肌少症对胃肠道肿瘤患者的手术结果有负面影响，但缺乏实用的术前筛查工具。CRP/ALB比值是一种新的全身性炎症和营养状况的生物标志物，可以增强肌肉减少症的预测，但在外科肿瘤学中仍未得到充分的探索。本研究旨在确定胃癌和结直肠癌患者术前肌肉减少的预测因素。方法：回顾性分析2019-2021年145例根治性手术患者。骨骼肌减少症通过性别特异性ct测量的L3骨骼肌指数来定义(截止值，男性≤40.8 cm2/m2；女性≤34.9 cm2/m2)。多变量逻辑回归确定预测因子，通过ROC分析和Cohen’s Kappa评估模型性能。结果：该队列(中位年龄64岁；73.8%男性)，包括66例胃癌（45.5%）和79例结直肠癌（54.5%），其中29例（20%）诊断为肌肉减少症。结论：CRP/ALB比值结合BMI和年龄可作为术前肌少症筛查的一种方便、有效的工具。这种模型驱动的方法提供了强大的策略，以促进术前干预，优化围手术期护理，并提高胃癌和结直肠癌手术患者的长期肿瘤预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.