CT‐determined low skeletal muscle index predicts poor prognosis in patients with colorectal cancer

• Published in: Cancer medicine (Malden, MA) MA), 2024-06, Vol.13 (12), p.e7328-n/a
• Main Authors: Feng, Yue, Cheng, Xiao‐Hong, Xu, Mei, Zhao, Rui, Wan, Qian‐Yi, Feng, Wei‐Hua, Gan, Hua‐Tian
• Format: Article
• Language: English
• Subjects: Abdomen; Aged; Body Mass Index; Cardiovascular disease; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - complications; Colorectal Neoplasms - diagnostic imaging; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Complications; Computed tomography; Coronary artery disease; Female; Females; Heart diseases; Hospitals; Humans; Leukocytes (neutrophilic); Lymphocytes; major complications; Male; Medical prognosis; Middle Aged; Mortality; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - pathology; Musculoskeletal system; Neutrophils; overall survival; Patients; Postoperative; Postoperative Complications - epidemiology; Prognosis; Regression analysis; Retrospective Studies; Risk factors; ROC Curve; Sarcopenia; Sarcopenia - diagnostic imaging; Skeletal muscle; Surgery; Surgical outcomes; Survival analysis; Tomography, X-Ray Computed - methods; Vertebrae
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.7328

Background Sarcopenia is highly prevalent among patients with colorectal cancer (CRC). Computed tomography (CT)‐based assessment of low skeletal muscle index (SMI) is widely used for diagnosing sarcopenia. However, there are conflicting findings on the association between low SMI and overall survival (OS) in CRC patients. The objective of this study was to investigate whether CT‐determined low SMI can serve as a valuable prognostic factor in CRC. Methods We collected data from patients with CRC who underwent radical surgery at our institution between June 2020 and November 2021. The SMI at the third lumbar vertebra was calculated using CT scans, and the cutoff values for defining low SMI were determined using receiver operating characteristic curves. Univariate and multivariate analyses were performed to assess the associations between clinical characteristics and postoperative major complications. Results A total of 464 patients were included in the study, 229 patients (46.7%) were classified as having low SMI. Patients with low SMI were older and had a lower body mass index (BMI), a higher neutrophil to lymphocyte ratio (NLR), and higher nutritional risk screening 2002 (NRS2002) scores compared to those with normal SMI. Furthermore, patients with sarcopenia had a higher rate of major complications (10.9% vs. 1.3%; p