The impact of sarcopenia and myosteatosis on postoperative outcomes and 5-year survival in curatively operated colorectal cancer patients - A retrospective register study

Autor: Pasi Ohtonen, Sanna Meriläinen, Elisa Mäkäräinen-Uhlbäck, Raila Aro, Tero Rautio, Juha Saarnio, Noora Ämmälä
Rok vydání: 2019
Předmět:
Lung Diseases
Male
Sarcopenia
Colorectal cancer
Myocardial Infarction
Anastomotic Leak
Kaplan-Meier Estimate
0302 clinical medicine
Postoperative Complications
Registries
Aged
80 and over
General Medicine
Middle Aged
Prognosis
Patient Discharge
Survival Rate
medicine.anatomical_structure
Oncology
Adipose Tissue
030220 oncology & carcinogenesis
Body Composition
030211 gastroenterology & hepatology
Female
Colorectal Neoplasms
Respiratory Insufficiency
Adult
medicine.medical_specialty
Heart Diseases
Rectum
03 medical and health sciences
Young Adult
Internal medicine
medicine
Humans
Risk factor
Muscle
Skeletal
Aged
Proportional Hazards Models
Retrospective Studies
Heart Failure
business.industry
Carcinoma
Cancer
Cardiorespiratory fitness
Pneumonia
medicine.disease
Pleural Effusion
Surgery
Complication
business
Pulmonary Embolism
Tomography
X-Ray Computed
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 46(9)
ISSN: 1532-2157
Popis: The aim of this study was to evaluate whether sarcopenia or myosteatosis have an impact on short- and long-term results in patients who were surgically treated for colorectal cancer.During 2007-2011 curatively treated colorectal cancer patients (n = 348) were included in the study. Clinical data was collected retrospectively from patient registers. Skeletal muscle mass was measured at the L3 level via venous-phase computed tomography and patients were divided into sarcopenic and non-sarcopenic and into myosteatotic and non-myosteatotic. Postoperative morbidity and mortality were analysed in these groups.Sarcopenia was found in 208 patients (59.8%) and myosteatosis was found in 108 patients (31.2%). Sarcopenia was associated with increased risk of postoperative pneumonia (6.7% vs. 1.4%, p = 0.021). Sarcopenic colon cancer patients had higher rate of cardiorespiratory complications than non-sarcopenic (6.3% vs. 0.0%, p = 0.023) and sarcopenic rectum cancer patients had more often pneumonia than non-sarcopenic (8.5% vs. 0.0%, p = 0.041). Discharge to home was less common in myosteatotic patients than in non-myosteatotic patients (47.7% vs. 76.9%, p 0.001) and also in sarcopenic patients than in non-sarcopenic patients (62.7% vs. 75.5%, p = 0.013). Myosteatotic patients had decreased overall survival according to a Kaplan-Meier analysis (p = 0.002) and in the multivariable-adjusted Cox model (HR = 1.6, p = 0.034).Sarcopenia increases the pneumonia and cardiorespiratory complication rates. Sarcopenia and myosteatosis predicts the need for institutional care after colorectal cancer surgery. Sarcopenia and myosteatosis seem to be negative factors for colorectal cancer patients' survival. Myosteatosis is an independent risk factor for poor overall 5-year survival.
Databáze: OpenAIRE
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