• Ryota Nakanishi, Eiji Oki, Shun Sasaki, Kosuke Hirose, Tomoko Jogo, Keitaro Edahiro, Shotaro Korehisa, Daisuke Taniguchi, Kensuke Kudo, Junji Kurashige, Masahiko Sugiyama, Yuichiro Nakashima, Kippei Ohgaki, Hiroshi Saeki, and Yoshihiko Maehara.
• Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan. naka-r@surg2.med.kyushu-u.ac.jp.
• Surg. Today. 2018 Feb 1; 48 (2): 151-157.

PurposeThe significance of sarcopenia after colorectal cancer (CRC) resection has only been discussed with relatively small samples or short follow-up periods. This study aimed to clarify the clinical significance of sarcopenia in a large-sample study.MethodsWe retrospectively analyzed the relationship between sarcopenia and clinical factors, surgical outcomes, and the survival in 494 patients who underwent CRC surgery between 2004 and 2013. Sarcopenia was defined based on the sex-specific skeletal muscle mass index measured by preoperative computed tomography.ResultsSarcopenia was associated with sex (higher rate of male, P < 0.0001), and low body mass index (P < 0.0001), but not age or tumor stage. Sarcopenia was associated with higher incidence of all postoperative complications (P = 0.02), especially for patients with Clavien-Dindo classification grade ≥2 (CDC; P = 0.0007). Postoperative hospital stays were significantly longer for sarcopenic patients than for non-sarcopenic patients (P = 0.02). In a multivariate analysis, sarcopenia was an independent predictor for postoperative complications (P = 0.01, odds ratio 1.82, 95% confidence interval 1.13-3.00). Among postoperative complications (CDC grade ≥2), sarcopenia was correlated with non-surgical-site infections (P = 0.03). Sarcopenia was not correlated with the overall or recurrence-free survival.ConclusionsSarcopenia was an independent predictive factor for postoperative complications after CRC surgery.

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