The relationship between sarcopenia and survival at 1 year in patients undergoing elective colorectal cancer surgery

Dolan, D.R., Knight, K.A., Maguire, S. and Moug, S.J. (2019) The relationship between sarcopenia and survival at 1 year in patients undergoing elective colorectal cancer surgery. Techniques in Coloproctology, 23, pp. 877-885. (doi: 10.1007/s10151-019-02072-0) (PMID:31486988) (PMCID:PMC6791904)

Abstract

Background: Colorectal cancer remains a common cause of cancer death in the UK, with surgery being the mainstay of treatment. An objective measurement of the suitability of each patient for surgery, and their risk–benefit calculation, would be of great utility. We postulate that sarcopenia (low muscle mass) could fulfil this role as a prognostic indicator. The aim of this study was to determine the relationship between sarcopenia and long-term outcomes in patients undergoing elective bowel resection for colorectal cancer. Methods: One hundred and sixty-three consecutive patients who had elective curative colorectal resection for cancer were eligible for inclusion in the study. Psoas muscle mass was assessed on preoperative computed tomography scan at the level of the L3 vertebra and standardised for patient height (total psoas index, TPI). Sarcopenia (low muscle mass) was defined as < 524 mm2/m2 in males and 385 mm2/m2 in females. In addition to clinical–pathological parameters, postoperative complications were recorded and patients were followed up for mortality for 1 year after surgery. Results: Sarcopenia was present in 19.6% of the study participants and was significantly related to body mass index (p = 0.007), 30-day mortality (p = 0.042) and 1-year mortality (p = 0.046). In univariate analysis, American Society of Anesthesiologists grade (p = 0.016), tumour stage (p = 0.018) and sarcopenia (p = 0.043) were found to be significant independent predictors of 1-year mortality. Conclusions: This study has found sarcopenia to be prevalent in patients with colorectal cancer having elective surgery. Independent of age, sarcopenia was associated with poorer 30-day mortality and survival at 1 year. Measurement of muscle mass preoperatively could be used to stratify a patient’s risk, allowing targeted strategies such as prehabilitation, to be implemented to modify sarcopenia and improve long-term outcomes for patients.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Moug, Ms Susan and Knight, Miss Katrina
• Authors: Dolan, D.R., Knight, K.A., Maguire, S., and Moug, S.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Techniques in Coloproctology
• Publisher: Springer
• ISSN: 1123-6337
• ISSN (Online): 1123-6337
• Published Online: 05 September 2019
• Copyright Holders: Copyright © The Authors 2019
• First Published: First published in Techniques in Coloproctology 23:877-885
• Publisher Policy: Reproduced under a Creative Commons license