Sarcopenia is an independent predictor of complications after colorectal cancer surgery

• Published in: Surgery today (Tokyo, Japan) Vol. 48; no. 2; pp. 151 - 157
• Main Authors: Nakanishi, Ryota, Oki, Eiji, Sasaki, Shun, Hirose, Kosuke, Jogo, Tomoko, Edahiro, Keitaro, Korehisa, Shotaro, Taniguchi, Daisuke, Kudo, Kensuke, Kurashige, Junji, Sugiyama, Masahiko, Nakashima, Yuichiro, Ohgaki, Kippei, Saeki, Hiroshi, Maehara, Yoshihiko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-02-2018
• Subjects: Aged; Body Mass Index; Colorectal Neoplasms - surgery; Female; Forecasting; Humans; Incidence; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Muscle, Skeletal - diagnostic imaging; Original Article; Postoperative Complications - epidemiology; Prognosis; Retrospective Studies; Sarcopenia - diagnostic imaging; Sex Characteristics; Surgery; Surgical Oncology; Tomography, X-Ray Computed; Sarcopenia; Postoperative complications; Colorectal cancer
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-017-1564-0

Purpose
The significance of sarcopenia after colorectal cancer (CRC) resection has only been discussed with relatively small samples or short follow-up periods. This study aimed to clarify the clinical significance of sarcopenia in a large-sample study.
Methods
We retrospectively analyzed the relationship between sarcopenia and clinical factors, surgical outcomes, and the survival in 494 patients who underwent CRC surgery between 2004 and 2013. Sarcopenia was defined based on the sex-specific skeletal muscle mass index measured by preoperative computed tomography.
Results
Sarcopenia was associated with sex (higher rate of male,
P
 < 0.0001), and low body mass index (
P
 < 0.0001), but not age or tumor stage. Sarcopenia was associated with higher incidence of all postoperative complications (
P
 = 0.02), especially for patients with Clavien–Dindo classification grade ≥2 (CDC;
P
 = 0.0007). Postoperative hospital stays were significantly longer for sarcopenic patients than for non-sarcopenic patients (
P
 = 0.02). In a multivariate analysis, sarcopenia was an independent predictor for postoperative complications (
P
 = 0.01, odds ratio 1.82, 95% confidence interval 1.13–3.00). Among postoperative complications (CDC grade ≥2), sarcopenia was correlated with non-surgical-site infections (
P
 = 0.03). Sarcopenia was not correlated with the overall or recurrence-free survival.
Conclusions
Sarcopenia was an independent predictive factor for postoperative complications after CRC surgery.