Preoperative evaluation of skeletal muscle mass in the risk assessment for the short-term outcome of elderly colorectal cancer patients undergoing colectomy

摘要

The prevalence of colorectal cancer in the elderly population is increasing; therefore, surgical interventions with a risk of potential complications are more frequently performed. The aim of the present study was to elucidate whether sarcopenia has a clinical impact on short-term outcomes, such as morbidity and hospital stay after surgery, in elderly patients with colorectal cancer. A total of 82 elderly patients undergoing colectomy for colorectal cancer between January 2011 and December 2015 in our institute were included in the study, and skeletal muscle mass was measured as total psoas area at the level of the third lumbar vertebra (L3) using enhanced computed tomography scans. The patients were divided into two subgroups, namely those with and those without sarcopenia, based on median skeletal muscle mass in men and women, and the association with complications was analyzed. A total of 40 patients (48.8%) were diagnosed with sarcopenia. The patients with sarcopenia exhibited a significantly higher incidence of total complications (55 vs. 31.0%, P=0.028) and longer hospital stay (25.9±21.2 vs. 18.2±8.5 days, P=0.039). The multivariate logistic analysis revealed that sarcopenia was an independent risk factor for postoperative surgical complications. The short-term outcomes, such as postoperative surgical complications and hospital stay, were affected by preoperative sarcopenia in elderly colorectal cancer patients. To improve the short-term outcomes of such patients, it is necessary to carefully plan the surgical procedure, perioperative care and the surgical strategy using preoperative sarcopenia assessment.