Abstract
PurposeProgressive loss (sarcopenia) and fatty infiltration of muscle mass (myosteatosis) are well-established risk factors for an adverse clinical outcome in obese patients. Data concerning non-obese sarcopenic patients in oncologic surgery are scarce and heterogeneous. The aim of this study was to determine the impact of sarcopenia and myosteatosis in non-obese patients with cancer of the right colon on clinical outcome.MethodsThis study comprised 85 patients with a BMI < 30 kg/m2, who underwent surgery for right colon cancer in a single center. Skeletal muscle area (SMA), visceral fat area (VFA), and myosteatosis were retrospectively assessed using preoperative abdominal CT images. Univariate und multivariate analysis was performed to evaluate the association between body composition, complications, and oncologic follow-up.ResultsTraditional risk factors such as visceral fat (p = 0.8653), BMI (p = 0.8033), myosteatosis (p = 0.7705), and sarcopenia (p = 0.3359) failed to show any impact on postoperative complications or early recurrence. In our cohort, the skeletal muscle index (SMI) was the only significant predictor for early cancer recurrence (p = 0.0467).ConclusionSMI is a significant prognostic factor for early cancer recurrence in non-obese colon cancer patients. Our study shows that conventional thresholds for sarcopenia and BMI do not seem to be reliable across various cohorts. Target prehabilitation programs could be useful to improve outcome after colorectal surgery.Trial RegistrationDRKS00014655, www.apps.who.int/trialsearch
Highlights
Sarcopenia and obesity represent major public health problems in the aging population
Differences in definitions and the wide range of thresholds for sarcopenia, myosteatosis, and visceral obesity are contributing to remarkable variations and hamper the application of findings in the clinical practice [22]
Evidence of sarcopenia being a risk factor after gastrointestinal tumor resection was rated as very low according to GRADE criteria [23]
Summary
Sarcopenia and obesity represent major public health problems in the aging population. Sarcopenia is commonly defined as a progressive loss of skeletal muscle mass and functional strength This muscle depletion is often accompanied by intra- and intermyocellular fatty infiltration (myosteatosis). Sarcopenia and myosteatosis were identified as prognostic factors in various malignancies and are associated with longer hospital stays, increased toxicity of chemotherapy, as well as postoperative morbidity and mortality [2,3,4]. These adverse effects have been demonstrated in patients with colorectal cancer (CRC) [2, 5,6,7,8,9,10]. The evidence is scarce so far to sufficiently demonstrate the effect of sarcopenia and myosteatosis in the non-obese colon cancer population
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