Impact of low skeletal muscle mass and density on short and long-term outcome after resection of stage I-III colorectal cancer
| Autor: | Wietske W. Vrijland, Robert R. J. Coebergh van den Braak, Jan Willem T. Dekker, Jan N. M. IJzermans, Peter-Paul L.O. Coene, Zarina S. Lalmahomed, David D. E. Zimmerman, W. J. Vles, Jeroen L.A. van Vugt |
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| Přispěvatelé: | Surgery |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Sarcopenia medicine.medical_specialty Time Factors Colorectal cancer Urology Comorbidity Disease-Free Survival Body Mass Index 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Risk Factors medicine Humans Postoperative Period Prospective Studies Stage (cooking) Muscle Skeletal Colectomy Aged Neoplasm Staging Netherlands business.industry Skeletal muscle Postoperative complication General Medicine Middle Aged medicine.disease Skeletal muscle mass Survival Rate medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Colorectal Neoplasms Tomography X-Ray Computed business Follow-Up Studies Cohort study |
| Zdroj: | European Journal of Surgical Oncology, 44(9), 1354-1360. W.B. Saunders |
| ISSN: | 0748-7983 |
| Popis: | Background Preoperative low skeletal muscle mass and density are associated with increased postoperative morbidity in patients undergoing curative colorectal cancer (CRC) surgery. However, the long-term effects of low skeletal muscle mass and density remain uncertain. Methods Patients with stage I-III CRC undergoing surgery, enrolled in a prospective observational cohort study, were included. Skeletal muscle mass and density were measured on CT. Patients with high and low skeletal muscle mass and density were compared regarding postoperative complications, disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). Results In total, 816 patients (53.9% males, median age 70) were included; 50.4% had low skeletal muscle mass and 64.1% low density. The severe postoperative complication rate was significantly higher in patients with low versus high skeletal muscle and density (20.9% versus 13.6%, p = 0.006; 20.0% versus 11.8%, p = 0.003). Low skeletal muscle mass (OR 1.91, p = 0.018) and density (OR 1.87, p = 0.045) were independently associated with severe postoperative complications. Ninety-day mortality was higher in patients with low skeletal muscle mass and density compared with patients with high skeletal muscle mass and density (3.6% versus 1.7%, p = 0.091; 3.4% versus 1.0%, p = 0.038). No differences in DFS were observed. After adjustment for covariates such as age and comorbidity, univariate differences in OS and CSS diminished. Conclusions Low skeletal muscle mass and density are associated with short-term, but not long-term, outcome in patients undergoing CRC surgery. These findings recommend putting more emphasis on preoperative management of patients at risk for surgical complications, but do not support benefit for long-term outcome. |
| Databáze: | OpenAIRE |
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