Prognostic value of myosteatosis and sarcopenia for elderly patients with colorectal cancer: A large-scale double-center study

医学 肌萎缩 低蛋白血症 结直肠癌 内科学 癌症 共病 比例危险模型 超重 外科 体质指数
作者
Weizhe Chen,Zi-Le Shen,Feng‐Min Zhang,Xianzhong Zhang,Wenhao Chen,Xialin Yan,Cheng‐Le Zhuang,Xiao-Lei Chen,Zhen Yu
出处
期刊:Surgery [Elsevier]
卷期号:172 (4): 1185-1193 被引量:25
标识
DOI:10.1016/j.surg.2022.05.031
摘要

Abstract

Background

Myosteatosis and sarcopenia are forms of muscle depletion that impair the normal physiological function of elderly patients, resulting in a worse prognosis. This study aimed to evaluate the prognostic value of sarcopenia and myosteatosis on postoperative outcomes in elderly patients with colorectal cancer.

Methods

From February 2015 to March 2021, a total of 921 elderly patients who underwent curative surgeries for colorectal cancer at 2 centers were enrolled and grouped by the presence of either myosteatosis or sarcopenia. Clinicopathological characteristics and postoperative outcomes were compared between the 2 groups. The independent risk factors for complications and overall survival were evaluated.

Results

Patients with myosteatosis had higher incidences of total and surgical complications, longer surgical duration, lower numbers of lymph nodes harvested, and longer postoperative hospital stays. Patients with sarcopenia had higher incidences of total complications, medical complications, and shorter surgical durations. Both conditions had adverse effects on overall survival and disease-free survival. Overweight status (P = .004), hypoalbuminemia (P < .001), myosteatosis, (P = .029) and sarcopenia (P = .017) were independent risk factors for total complications. Hypoalbuminemia (P = .035), myosteatosis (P = .003), sarcopenia (P = .027), and tumor-nodes-metastasis stage (≥Ⅲ; P < .001) were independent negative prognostic factors for overall survival.

Conclusion

Myosteatosis and sarcopenia have different characteristics and are associated with poor prognoses in elderly patients with colorectal cancer. Myosteatosis occurs more frequently. Early diagnosis and intervention for myosteatosis should be included in preoperative management, which may improve prognosis in elderly patients.
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