The impact of sarcopenia and myosteatosis on postoperative outcomes and 5-year survival in curatively operated colorectal cancer patients – A retrospective register study

• Published in: European journal of surgical oncology Vol. 46; no. 9; pp. 1656 - 1662
• Main Authors: Aro, Raila, Mäkäräinen-Uhlbäck, Elisa, Ämmälä, Noora, Rautio, Tero, Ohtonen, Pasi, Saarnio, Juha, Meriläinen, Sanna
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2020
• Subjects: Adipose Tissue - diagnostic imaging; Adult; Aged; Aged, 80 and over; Anastomotic Leak - epidemiology; Body Composition; Carcinoma - epidemiology; Carcinoma - pathology; Carcinoma - surgery; Colorectal cancer; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Female; Heart Diseases - epidemiology; Heart Failure - epidemiology; Humans; Kaplan-Meier Estimate; Lung Diseases - epidemiology; Male; Middle Aged; Muscle, Skeletal - diagnostic imaging; Myocardial Infarction - epidemiology; Myosteatosis; Patient Discharge; Pleural Effusion - epidemiology; Pneumonia - epidemiology; Postoperative Complications - epidemiology; Prognosis; Proportional Hazards Models; Pulmonary Embolism - epidemiology; Registries; Respiratory Insufficiency - epidemiology; Retrospective Studies; Sarcopenia; Sarcopenia - diagnostic imaging; Sarcopenia - epidemiology; Survival Rate; Tomography, X-Ray Computed; Young Adult; Sarcopenia; Myosteatosis; Colorectal cancer
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2020.03.206

The aim of this study was to evaluate whether sarcopenia or myosteatosis have an impact on short- and long-term results in patients who were surgically treated for colorectal cancer. During 2007–2011 curatively treated colorectal cancer patients (n = 348) were included in the study. Clinical data was collected retrospectively from patient registers. Skeletal muscle mass was measured at the L3 level via venous-phase computed tomography and patients were divided into sarcopenic and non-sarcopenic and into myosteatotic and non-myosteatotic. Postoperative morbidity and mortality were analysed in these groups. Sarcopenia was found in 208 patients (59.8%) and myosteatosis was found in 108 patients (31.2%). Sarcopenia was associated with increased risk of postoperative pneumonia (6.7% vs. 1.4%, p = 0.021). Sarcopenic colon cancer patients had higher rate of cardiorespiratory complications than non-sarcopenic (6.3% vs. 0.0%, p = 0.023) and sarcopenic rectum cancer patients had more often pneumonia than non-sarcopenic (8.5% vs. 0.0%, p = 0.041). Discharge to home was less common in myosteatotic patients than in non-myosteatotic patients (47.7% vs. 76.9%, p < 0.001) and also in sarcopenic patients than in non-sarcopenic patients (62.7% vs. 75.5%, p = 0.013). Myosteatotic patients had decreased overall survival according to a Kaplan-Meier analysis (p = 0.002) and in the multivariable-adjusted Cox model (HR = 1.6, p = 0.034). Sarcopenia increases the pneumonia and cardiorespiratory complication rates. Sarcopenia and myosteatosis predicts the need for institutional care after colorectal cancer surgery. Sarcopenia and myosteatosis seem to be negative factors for colorectal cancer patients’ survival. Myosteatosis is an independent risk factor for poor overall 5-year survival.