The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019

Abstract Background Sarcopenia predicts worse postoperative outcomes and lower survival rates in patients with colorectal cancer (CRC). There is a scarcity of studies on the most effective assessment tools for detecting sarcopenia in preoperative elderly patients with CRC. Our objective was to compa...

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Main Authors: Ling Li, Mengchen Xing, Rong Wang, Xiaoyue Ding, Xia Wan, Xin Yu
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05806-y
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author Ling Li
Mengchen Xing
Rong Wang
Xiaoyue Ding
Xia Wan
Xin Yu
author_facet Ling Li
Mengchen Xing
Rong Wang
Xiaoyue Ding
Xia Wan
Xin Yu
author_sort Ling Li
collection DOAJ
description Abstract Background Sarcopenia predicts worse postoperative outcomes and lower survival rates in patients with colorectal cancer (CRC). There is a scarcity of studies on the most effective assessment tools for detecting sarcopenia in preoperative elderly patients with CRC. Our objective was to compare the diagnostic accuracy of various tools such as calf circumference (CC), strength, need for assistance with walking, rising from a sitting position, climbing stairs, and the incidence of falls (SARC-F), SARC-F plus CC (SARC-CalF), the short version of mini sarcopenia risk assessment (MSRA-5), the full version of mini sarcopenia risk assessment (MSRA-7), and Ishii score chart in screening sarcopenia in preoperative elderly patients with CRC. Methods During the period of April 2021 to September 2023, we conducted a cross-sectional study involving consecutive elderly patients who were undergoing colorectal surgery. Sarcopenia was defined using the diagnostic criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) and the 2019 Asian Working Group for Sarcopenia (AWGS2019). The screening tools’ performances were evaluated through receiver operating characteristic (ROC) curves, area under the ROC curves (AUC), and sensitivity/specificity analyses, based on the criteria proposed by EWGSOP2 and AWGS2019. Results We enrolled 482 patients with an average age of 71.86 ± 5.60 years. According to the EWGSOP2 and AWGS2019 diagnostic standards, the incidence of sarcopenia was 19.5% and 21.6% respectively. The sensitivity of SARC-F, SARC-CalF, MSRA-5, MSRA-7, and Ishii score chart ranged from 51.92 to 56.38%, 84.62–85.11%, 86.54–88.30%, 65.96–67.31%, and 73.08–74.47% respectively, while the specificity ranged from 84.92 to 85.05%, 70.36–71.69%, 36.86–37.04%, 60.57–61.64%, and 77.32–78.31% respectively. Regardless of the sarcopenia diagnostic criteria used, the AUCs of Ishii score chart (0.87 to 0.88) and SARC-CalF (0.89 to 0.90) were significantly larger than those of other tools (P<0.05). There was no significant difference in AUCs among SARC-F, SARC-CalF, and Ishii score chart in females. Conclusion Among the five sarcopenia screening tools, Ishii score chart and SARC-CalF had the largest overall diagnostic accuracy for sarcopenia in preoperative elderly patients with CRC.
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spelling doaj-art-e3216da2325a404b8b13b74fbb5749a32025-08-20T03:40:44ZengBMCBMC Geriatrics1471-23182025-03-0125111110.1186/s12877-025-05806-yThe predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019Ling Li0Mengchen Xing1Rong Wang2Xiaoyue Ding3Xia Wan4Xin Yu5Department of Thyroid, Breast, and Gastrointestinal Surgery, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Thyroid, Breast, and Gastrointestinal Surgery, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Geriatric Medicine, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Thyroid, Breast, and Gastrointestinal Surgery, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Geriatric Medicine, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Hepatobiliary Surgery, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University,, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityAbstract Background Sarcopenia predicts worse postoperative outcomes and lower survival rates in patients with colorectal cancer (CRC). There is a scarcity of studies on the most effective assessment tools for detecting sarcopenia in preoperative elderly patients with CRC. Our objective was to compare the diagnostic accuracy of various tools such as calf circumference (CC), strength, need for assistance with walking, rising from a sitting position, climbing stairs, and the incidence of falls (SARC-F), SARC-F plus CC (SARC-CalF), the short version of mini sarcopenia risk assessment (MSRA-5), the full version of mini sarcopenia risk assessment (MSRA-7), and Ishii score chart in screening sarcopenia in preoperative elderly patients with CRC. Methods During the period of April 2021 to September 2023, we conducted a cross-sectional study involving consecutive elderly patients who were undergoing colorectal surgery. Sarcopenia was defined using the diagnostic criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) and the 2019 Asian Working Group for Sarcopenia (AWGS2019). The screening tools’ performances were evaluated through receiver operating characteristic (ROC) curves, area under the ROC curves (AUC), and sensitivity/specificity analyses, based on the criteria proposed by EWGSOP2 and AWGS2019. Results We enrolled 482 patients with an average age of 71.86 ± 5.60 years. According to the EWGSOP2 and AWGS2019 diagnostic standards, the incidence of sarcopenia was 19.5% and 21.6% respectively. The sensitivity of SARC-F, SARC-CalF, MSRA-5, MSRA-7, and Ishii score chart ranged from 51.92 to 56.38%, 84.62–85.11%, 86.54–88.30%, 65.96–67.31%, and 73.08–74.47% respectively, while the specificity ranged from 84.92 to 85.05%, 70.36–71.69%, 36.86–37.04%, 60.57–61.64%, and 77.32–78.31% respectively. Regardless of the sarcopenia diagnostic criteria used, the AUCs of Ishii score chart (0.87 to 0.88) and SARC-CalF (0.89 to 0.90) were significantly larger than those of other tools (P<0.05). There was no significant difference in AUCs among SARC-F, SARC-CalF, and Ishii score chart in females. Conclusion Among the five sarcopenia screening tools, Ishii score chart and SARC-CalF had the largest overall diagnostic accuracy for sarcopenia in preoperative elderly patients with CRC.https://doi.org/10.1186/s12877-025-05806-yColorectal cancerSarcopeniaScreening toolsPreoperativeElderly patients
spellingShingle Ling Li
Mengchen Xing
Rong Wang
Xiaoyue Ding
Xia Wan
Xin Yu
The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019
BMC Geriatrics
Colorectal cancer
Sarcopenia
Screening tools
Preoperative
Elderly patients
title The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019
title_full The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019
title_fullStr The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019
title_full_unstemmed The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019
title_short The predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer: applying the diagnostic criteria of EWGSOP2 and AWGS2019
title_sort predictive values of sarcopenia screening tools in preoperative elderly patients with colorectal cancer applying the diagnostic criteria of ewgsop2 and awgs2019
topic Colorectal cancer
Sarcopenia
Screening tools
Preoperative
Elderly patients
url https://doi.org/10.1186/s12877-025-05806-y
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