The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery
Abstract Background The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer has not been exhaustively investigated. Thus, the present study was performed to evaluate the effect of sarcopenia on the outcome of patients with left-sided colon and rectal cancer. Metho...
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BMC
2023-07-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11073-0 |
| _version_ | 1797778845340794880 |
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| author | Qi Li Tailai An Jianbin Wu Weiqi Lu Yan Wang Jia Li Lina Yang Yiqi Chen Lizhu Lin Zhenjiang Yang |
| author_facet | Qi Li Tailai An Jianbin Wu Weiqi Lu Yan Wang Jia Li Lina Yang Yiqi Chen Lizhu Lin Zhenjiang Yang |
| author_sort | Qi Li |
| collection | DOAJ |
| description | Abstract Background The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer has not been exhaustively investigated. Thus, the present study was performed to evaluate the effect of sarcopenia on the outcome of patients with left-sided colon and rectal cancer. Methods Patients with pathologically diagnosed stage I, II and III left-sided colon or rectal cancer who had undergone curative surgery between January 2008 and December 2014 were retrospectively reviewed. The psoas muscle index (PMI) identified by 3D-image analysis of computed tomographic images was the criterion used to diagnose sarcopenia. The cut-off value recommended by Hamaguchi (PMI value < 6.36 cm2/m2 for men and < 3.92 cm2/m2 for women) was adopted to confirm the diagnosis of sarcopenia. According to the PMI, each patient was divided into the sarcopenia group (SG) or the nonsarcopenia group (NSG). Then, the SG was compared with the NSG in terms of postoperative outcomes. Results Among the 939 patients included, 574 (61.1%) were confirmed to have preoperative sarcopenia. Initially, it was demonstrated that the SG was not significantly different from the NSG in terms of most baseline characteristics except for a lower body mass index (BMI) (P < 0.001), a larger tumour size (P < 0.001) and more weight loss (more than 3 kg in the last three months) (P = 0.033). The SG had a longer hospital stay after surgery (P = 0.040), more intraoperative blood transfusions (P = 0.035), and higher incidence of anastomotic fistula (P = 0.027), surgical site infection (SSI) (P = 0.037) and hypoalbuminemia (P = 0.022), 30-day mortality (P = 0.042) and 90-day mortality (P = 0.041). The SG had significantly worse overall survival (OS) (P = 0.016) and recurrence-free survival (RFS) (P = 0.036) than the NSG. Subsequently, Cox regression analysis revealed that preoperative sarcopenia was an independent predictive factor for worse OS (P = 0.0211, HR = 1.367, 95% CI: 1.049–1.782) and RFS (P = 0.045, HR = 1.299, 95% CI: 1.006–1.677). Conclusion Preoperative sarcopenia adversely affects the outcome of patients with left-sided colon and rectal cancer, and preoperative nutrition supplementation may help us improve their long-term and short-term outcomes. |
| first_indexed | 2024-03-12T23:23:25Z |
| format | Article |
| id | doaj.art-92320256953d487f9d440e5dd9d7f23b |
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| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-12T23:23:25Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-92320256953d487f9d440e5dd9d7f23b2023-07-16T11:19:44ZengBMCBMC Cancer1471-24072023-07-0123111310.1186/s12885-023-11073-0The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgeryQi Li0Tailai An1Jianbin Wu2Weiqi Lu3Yan Wang4Jia Li5Lina Yang6Yiqi Chen7Lizhu Lin8Zhenjiang Yang9Department of Medical Oncology, The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Hepatobiliary and Pancreatic Surgery, Shenzhen People’s HospitalDepartment of Medical Oncology, The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Gastrointestinal Surgery, The First Hospital, Guangzhou University of Traditional Chinese MedicineDepartment of Radiology, Shenzhen People’s HospitalThe First Department of Surgery, The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Medical Oncology, The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Medical Oncology, The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineDepartment of Medical Oncology, The First Affiliated Hospital, Guangzhou University of Traditional Chinese MedicineDepartment of Medical Oncology, The Fourth Clinical Medical College of Guangzhou University of Chinese MedicineAbstract Background The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer has not been exhaustively investigated. Thus, the present study was performed to evaluate the effect of sarcopenia on the outcome of patients with left-sided colon and rectal cancer. Methods Patients with pathologically diagnosed stage I, II and III left-sided colon or rectal cancer who had undergone curative surgery between January 2008 and December 2014 were retrospectively reviewed. The psoas muscle index (PMI) identified by 3D-image analysis of computed tomographic images was the criterion used to diagnose sarcopenia. The cut-off value recommended by Hamaguchi (PMI value < 6.36 cm2/m2 for men and < 3.92 cm2/m2 for women) was adopted to confirm the diagnosis of sarcopenia. According to the PMI, each patient was divided into the sarcopenia group (SG) or the nonsarcopenia group (NSG). Then, the SG was compared with the NSG in terms of postoperative outcomes. Results Among the 939 patients included, 574 (61.1%) were confirmed to have preoperative sarcopenia. Initially, it was demonstrated that the SG was not significantly different from the NSG in terms of most baseline characteristics except for a lower body mass index (BMI) (P < 0.001), a larger tumour size (P < 0.001) and more weight loss (more than 3 kg in the last three months) (P = 0.033). The SG had a longer hospital stay after surgery (P = 0.040), more intraoperative blood transfusions (P = 0.035), and higher incidence of anastomotic fistula (P = 0.027), surgical site infection (SSI) (P = 0.037) and hypoalbuminemia (P = 0.022), 30-day mortality (P = 0.042) and 90-day mortality (P = 0.041). The SG had significantly worse overall survival (OS) (P = 0.016) and recurrence-free survival (RFS) (P = 0.036) than the NSG. Subsequently, Cox regression analysis revealed that preoperative sarcopenia was an independent predictive factor for worse OS (P = 0.0211, HR = 1.367, 95% CI: 1.049–1.782) and RFS (P = 0.045, HR = 1.299, 95% CI: 1.006–1.677). Conclusion Preoperative sarcopenia adversely affects the outcome of patients with left-sided colon and rectal cancer, and preoperative nutrition supplementation may help us improve their long-term and short-term outcomes.https://doi.org/10.1186/s12885-023-11073-0SarcopeniaLeft-sided colon cancer and rectal cancerPsoas muscle indexShort-term and long-term outcome |
| spellingShingle | Qi Li Tailai An Jianbin Wu Weiqi Lu Yan Wang Jia Li Lina Yang Yiqi Chen Lizhu Lin Zhenjiang Yang The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery BMC Cancer Sarcopenia Left-sided colon cancer and rectal cancer Psoas muscle index Short-term and long-term outcome |
| title | The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery |
| title_full | The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery |
| title_fullStr | The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery |
| title_full_unstemmed | The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery |
| title_short | The impact of sarcopenia on the outcome of patients with left-sided colon and rectal cancer after curative surgery |
| title_sort | impact of sarcopenia on the outcome of patients with left sided colon and rectal cancer after curative surgery |
| topic | Sarcopenia Left-sided colon cancer and rectal cancer Psoas muscle index Short-term and long-term outcome |
| url | https://doi.org/10.1186/s12885-023-11073-0 |
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