Prognostic role of pre-sarcopenia and body composition with long-term outcomes in obstructive colorectal cancer: a retro
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(2020) 18:230
RESEARCH
Open Access
Prognostic role of pre-sarcopenia and body composition with long-term outcomes in obstructive colorectal cancer: a retrospective cohort study Chul Seung Lee1,2 , Daeyoun David Won1 , Soon Nam Oh3,4 , Yoon Suk Lee1 , In Kyu Lee1 , In-Ho Kim5 , Moon Hyung Choi6 and Seong Taek Oh7*
Abstract Background: The clinical significance of pre-sarcopenia in colorectal cancer obstruction has not yet been described. The present study aimed to determine the short- and long-term oncologic impacts of pre-sarcopenia in obstructive colorectal cancer. Methods: We retrospectively analyzed 214 patients with obstructive colon cancer between January 2004 and December 2013. Initial staging computed tomography (CT) scans identified pre-sarcopenia and visceral obesity by measuring the muscle and visceral fat areas at the third lumbar vertebra level. Both short-term postoperative and long-term oncologic outcomes were analyzed. Results: Among all 214 patients, 71 (33.2%) were diagnosed with pre-sarcopenia. Pre-sarcopenia had a negative oncologic impact in both disease-free survival (DFS) and overall survival (OS), (hazard ratio [HR] = 1.86, 95% confidence interval [CI] 1.04–3.13, p = 0.037, and HR = 1.92, CI 1.02–3.60, p = 0.043, respectively). Visceral adiposity, body mass index (BMI), and neutrophil-lymphocyte ratio (NLR) did not significantly impact DFS and OS. Conclusion: Pre-sarcopenia is a clinical factor significantly associated with OS and DFS but not with short-term complications in obstructive colorectal cancer. In future, prospective studies should incorporate body composition data in patient risk assessments and oncologic prediction tools. Keywords: Sarcopenia, Body composition, Colorectal neoplasms, Self-expandable metallic stents
Background Sarcopenia is defined as a decrease in skeletal muscle volume and function [1] that has been reported to reflect patients’ frailty. Major clinical guidelines have incorporated sarcopenia as a tool to assess cachexia in cancer patients [2]. Sarcopenia patients may possess unfavorable * Correspondence: [email protected] 7 Department of Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 271, Cheonbo-Ro, Uijeongbu-si, Gyeonggi-do, 11765 Seoul, Republic of Korea Full list of author information is available at the end of the article
nutritional and immunological factors [3] and show lower compliance to consecutive anti-tumor treatments such as radiotherapy, surgery, and chemotherapy [4]. Sarcopenia, especially in obese patients, is not easily characterized by overall weight loss or decreased body mass index (BMI) alone [5]. With an increased prevalence of obesity, patients with both sarcopenia and obesity (sarcopenic obesity) are at a higher risk of adverse outcomes [6] and mortality [7]. Thus, measuring the skeletal muscle mass and quality with BMI alone may not be appropriate in such cases. As reported,
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 Internati
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