Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery
<b>Background:</b> Patients with rectal cancer may be exposed to a loss of muscle strength and quality. This study aimed to assess the role of preoperative CT-based sarcopenia on postoperative clinical, pathological, and oncological outcomes after rectal cancer surgery. <b>Methods:...
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2025-03-01
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| author | David Martin Mathilde Billy Fabio Becce Damien Maier Michael Schneider Clarisse Dromain Dieter Hahnloser Martin Hübner Fabian Grass |
| author_facet | David Martin Mathilde Billy Fabio Becce Damien Maier Michael Schneider Clarisse Dromain Dieter Hahnloser Martin Hübner Fabian Grass |
| author_sort | David Martin |
| collection | DOAJ |
| description | <b>Background:</b> Patients with rectal cancer may be exposed to a loss of muscle strength and quality. This study aimed to assess the role of preoperative CT-based sarcopenia on postoperative clinical, pathological, and oncological outcomes after rectal cancer surgery. <b>Methods:</b> This retrospective monocentric study included patients who underwent elective oncologic resection for rectal adenocarcinoma between 01/2014 and 03/2022. The skeletal muscle index (SMI) was measured using CT at the third lumbar vertebral level, and sarcopenia was defined based on pre-established sex-specific cut-offs. Patients with sarcopenia were compared to those without sarcopenia in terms of outcomes. A Cox proportional hazard regression analysis was used to determine the independent prognostic factors of disease-free survival (DFS) and overall survival (OS). <b>Results:</b> A total of 208 patients were included, and 123 (59%) had preoperative sarcopenia. Patients with sarcopenia were significantly older (66 vs. 61 years, <i>p</i> = 0.003), had lower BMI (24 vs. 28 kg/m<sup>2</sup>, <i>p</i> < 0.001), and were mainly men (76 vs. 48%, <i>p</i> < 0.001). There was no difference in overall and major complication rates between the sarcopenia and non-sarcopenia group (43 vs. 37%, <i>p</i> = 0.389, and 17 vs. 17%, <i>p</i> = 1.000, respectively). Preoperative and postoperative features related to rectal surgery were comparable. The only predictive factor impacting OS was R1/R2 resection (HR 4.915, 95% CI, 1.141–11.282, <i>p</i> < 0.001), while sarcopenia (HR 2.013, 95% CI 0.972–4.173, <i>p</i> = 0.050) and T3/T4 status (HR 2.108, 95% CI 1.058–4.203, <i>p</i> = 0.034) were independently associated with DFS. <b>Conclusions:</b> A majority of patients undergoing rectal cancer surgery had preoperative CT-based sarcopenia. In this cohort, sarcopenia had no impact on postoperative morbidity and OS but was independently associated with DFS. |
| format | Article |
| id | doaj-art-66c4a3cdf953452ebfe3a11fac47f828 |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-66c4a3cdf953452ebfe3a11fac47f8282025-08-20T02:58:58ZengMDPI AGDiagnostics2075-44182025-03-0115562910.3390/diagnostics15050629Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer SurgeryDavid Martin0Mathilde Billy1Fabio Becce2Damien Maier3Michael Schneider4Clarisse Dromain5Dieter Hahnloser6Martin Hübner7Fabian Grass8Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, Switzerland<b>Background:</b> Patients with rectal cancer may be exposed to a loss of muscle strength and quality. This study aimed to assess the role of preoperative CT-based sarcopenia on postoperative clinical, pathological, and oncological outcomes after rectal cancer surgery. <b>Methods:</b> This retrospective monocentric study included patients who underwent elective oncologic resection for rectal adenocarcinoma between 01/2014 and 03/2022. The skeletal muscle index (SMI) was measured using CT at the third lumbar vertebral level, and sarcopenia was defined based on pre-established sex-specific cut-offs. Patients with sarcopenia were compared to those without sarcopenia in terms of outcomes. A Cox proportional hazard regression analysis was used to determine the independent prognostic factors of disease-free survival (DFS) and overall survival (OS). <b>Results:</b> A total of 208 patients were included, and 123 (59%) had preoperative sarcopenia. Patients with sarcopenia were significantly older (66 vs. 61 years, <i>p</i> = 0.003), had lower BMI (24 vs. 28 kg/m<sup>2</sup>, <i>p</i> < 0.001), and were mainly men (76 vs. 48%, <i>p</i> < 0.001). There was no difference in overall and major complication rates between the sarcopenia and non-sarcopenia group (43 vs. 37%, <i>p</i> = 0.389, and 17 vs. 17%, <i>p</i> = 1.000, respectively). Preoperative and postoperative features related to rectal surgery were comparable. The only predictive factor impacting OS was R1/R2 resection (HR 4.915, 95% CI, 1.141–11.282, <i>p</i> < 0.001), while sarcopenia (HR 2.013, 95% CI 0.972–4.173, <i>p</i> = 0.050) and T3/T4 status (HR 2.108, 95% CI 1.058–4.203, <i>p</i> = 0.034) were independently associated with DFS. <b>Conclusions:</b> A majority of patients undergoing rectal cancer surgery had preoperative CT-based sarcopenia. In this cohort, sarcopenia had no impact on postoperative morbidity and OS but was independently associated with DFS.https://www.mdpi.com/2075-4418/15/5/629sarcopeniacomputed tomographyrectal cancersurgeryoutcomes |
| spellingShingle | David Martin Mathilde Billy Fabio Becce Damien Maier Michael Schneider Clarisse Dromain Dieter Hahnloser Martin Hübner Fabian Grass Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery Diagnostics sarcopenia computed tomography rectal cancer surgery outcomes |
| title | Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery |
| title_full | Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery |
| title_fullStr | Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery |
| title_full_unstemmed | Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery |
| title_short | Impact of Preoperative CT-Measured Sarcopenia on Clinical, Pathological, and Oncological Outcomes After Elective Rectal Cancer Surgery |
| title_sort | impact of preoperative ct measured sarcopenia on clinical pathological and oncological outcomes after elective rectal cancer surgery |
| topic | sarcopenia computed tomography rectal cancer surgery outcomes |
| url | https://www.mdpi.com/2075-4418/15/5/629 |
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