A Retrospective Study: The Effects Of Sarcopenia On Post-surgical Clinical Outcome Of Patients With Colorectal Cancer

Background:sarcopenia,a syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability,poor quality of life and death has been associated with poor clinical outcome in patients undergoing cancer treatments.Colorectal cancer(CRC)is the third most common malignant neoplasm worldwide,The prevalence of colorectal cancer and sarcopenia in the elderly is increasing.Surgical resection is the cornerstone of treatment for CRC.About a third of patients suffer complications within 30 days.The presence of postoperative complication not only affects the short-term results of resection of colorectal cancer,but the long-term oncologic outcomes are also adversely affected.Long-term outcomes can be improved with efforts to reduce postoperative complications.The research on the effect of sarcopenia on post-surgical outcomes of patients with colorectal cancer was limitedly conducted in western countries and its conclusion is controversial.it still has just started in China.Objective:To test the prevalence of sarcopenia and its relation with the clinical outcome.To find the co-existing factors for sarcopenia.Methods : We conducted a retrospective analysis of 399 consecutive patients with primary CRC who underwent curative resection from June 2014 to June 2016.Sarcopenia was assessed using the L3 muscle index utilizing software on preoperative computed tomography.For woman Sarcopenia was defined as L3 muscle index(cm2∕㎡)<38.5 cm2∕㎡,For man Sarcopenia was defined as L3 muscle index(cm2∕㎡)< 52.4 cm2∕㎡.The factors contributing to complications were analyzed by univariate and multivariate Cox proportional hazard models.Results : Of 399 patients who met our inclusion criteria,284(71.17 %)had sarcopenia.The occurrence rate in male was higher than that in female(76.6% vs 33.1%,p=0.002).Patients with sarcopenia were older and had Lower BMI than patients without sarcopenia.The smoking rates in patients with sarcopenia was higher than patients without sarcopenia.The complication rate was 36.3%.The incidences of complications were significantly higher in patients with sarcopenia than those without(39.3% vs 28.7%,p = 0.043).Multivariate Cox regression analysis revealed that sarcopenia was independently associated with complications(hazard ratio[HR]1.68;95 % confidence interval [CI] 1.022–2.75;p =0.041).The incidence of anastomotic fistula were higher in patients with sarcopenia than those without sarcopenia(7.02% vs 1.74%,p=0.036).Multivariate Cox regression analysis revealed that sarcopenia was not an independently risk for anastomotic fistula(p=0.16)Conclusion : Preoperative sarcopenia defined by CT is a risk factor for postoperative complications in CRC patients undergoing colorectal surgery.The prevalence of sarcopenia in this region is higher.