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Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer.

Abstract：

BACKGROUND:The prevalence of colorectal cancer in the elderly is increasing and, therefore, surgical interventions with a risk of potential complications are more frequently performed. This study investigated the role of low skeletal muscle mass (sarcopenia), muscle quality, and the sarcopenic obesity as prognostic factors for postoperative complications and survival in patients with resectable colon cancer. METHODS:We conducted a retrospective chart review of 91 consecutive patients who underwent an elective open colon resection for cancer with primary anastomosis between 2011 and 2013. Skeletal muscle mass was measured as total psoas area (TPA) and total abdominal muscle area (TAMA) at three anatomical levels on the preoperative CT scan. Skeletal muscle quality was measured using corresponding mean Hounsfield units (HU) for TAMA. Their relation with complications (none vs one or more), severe complications, and survival was analyzed. RESULTS:The study included 91 patients with a mean age of 71.2 ± 9.7 years. Complications were noted in 55 patients (60 %), of which 15 (16.4 %) were severe. Lower HU for TAMA, as an indicator for impaired skeletal muscle quality, was an independent risk factor for one or more complications (all P ≤ 0.002), while sarcopenic obesity (TPA) was an independent risk factor for severe complications (all P ≤ 0.008). Sarcopenia was an independent predictor of worse overall survival (HR 8.54; 95 % confidence interval (CI) 1.07-68.32). CONCLUSION:Skeletal muscle quality is a predictor for overall complications, whereas sarcopenic obesity is a predictor for severe postoperative complications after open colon resection for cancer. Sarcopenia on itself is a predictor for worse overall survival.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Boer BC,de Graaff F,Brusse-Keizer M,Bouman DE,Slump CH,Slee-Valentijn M,Klaase JM

doi

10.1007/s00384-016-2538-1

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

1117-24

issue

eissn

0179-1958

issn

1432-1262

pii

10.1007/s00384-016-2538-1

journal_volume

pub_type

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Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer.