Characteristics Of Sarcopenia In Middle-aged And Elderly Patients With Gastrointestinal Malignancies

ObjectiveMuscle mass decreases gradually with aging.Progressive muscle protein wasting and low intake lead to sarcopenia and it is common among middle-aged and the elderly patients with gastrointestinal malignancy.The effect of sarcopenia on gastrointestinal malignancies outcome remains evident.We will investigate the prevalence of sarcopenia,analyze related risk factors among middle-aged and elderly patients with gastrointestinal malignancy,thus providing new strategy for them.MethodsA total of 255(167 patients with gastrointestinal malignancy and 88 patients without cancer)were included.The primary observations were computed tomographydefined L3 skeletal muscle mass index(L3 SMI,parameter of sarcopenia),body mass index(BMI),postoperative complications and the postoperative length of hospital stay.The basic patients data was obtained from digital patient record system.ResultsSarcopenia occurred to healthy middle-aged people without cancer(31.1%).The prevalence of sarcopenia in middle-aged males was significantly different from females,but not in elderly patients(middle-aged males vs.females: 47.8% vs.13.6%,P<0.05;elderly males vs.females:57.1% vs.36.4%,P>0.05).The prevalence of sarcopenia among patients with gastrointestinal malignancy was different from control(the middle-aged without vs.with cancer: 31.1% vs.37.3 %,P>0.05;the elderly without vs.with cancer: 46.5% vs.60.0%,P>0.05).The prevalence of sarcopenia among patients with gastrointestinal malignancy was age and gender-dependent(the middle-aged vs.the elderly: 37.3% vs.60.0%,P<0.05;males vs.females: 71.0% vs.20.9%,P<0.05).Prevalence of sarcopenia among patients with colorectal cancer increased with aging and differed by gender(the middle-aged vs.the elderly: 39.1% vs.63.3%,P<0.05;the middle-aged males vs.females: 65.2% vs.13.0%,P<0.05;the elderly males vs.females:84.0% vs.27.6%,P<0.05).Prevalence of sarcopenia among patients with gastrointestinal malignancy was BMI-dependent(low BMI 87.5%、normal BMI 56.1%、high BMI 30.2%,P<0.05).L3 SMI is positively correlated with BMI(Pearson correlation coefficient: 0.504,P<0.05).Among cancer patients,proportion of anastomotic leak(10/85 vs.2/82,P<0.05)was significantly different between sarcopenia and non-sarcopenia patients,but the prevalence of prolonged hospital stay,incision infection,bleeding and postoperative pneumonia between them weren’t statistically significant.ConclusionsSarcopenia frequently occur to both healthy people and those with gastrointestinal malignancy,and the prevalence increases with aging.The prevalence of sarcopenia among patients with colorectal cancer was age and gender-dependent.Furthermore,skeletal muscle mass index is positively correlated with BMI.Proportion of anastomotic leak was significantly different between sarcopenia and non-sarcopenia patients.It is important to early screen sarcopenia in gastrointestinal malignancies patients for better prognosis.