title: Sarcopenia is a Negative Prognostic Factor After Curative Resection of Colorectal Cancer.
abstract: BACKGROUND
  Skeletal muscle depletion (sarcopenia) is closely associated with limited physical ability and high mortality. This study was performed to evaluate the prognostic significance of skeletal muscle depletion in patients with resectable stage I-III colorectal cancer (CRC).
  
  
  METHODS
  We conducted a retrospective analysis of 220 consecutive patients with stage I-III CRC who underwent curative resection. The skeletal muscle cross-sectional area was measured by preoperative computed tomography. The lowest sex-specific quartile of skeletal muscle mass was classified as sarcopenia. Factors contributing to recurrence-free survival (RFS) were analyzed by univariate and multivariate Cox proportional hazard models.
  
  
  RESULTS
  Of 220 patients who met our inclusion criteria, 55 (25 %) had sarcopenia. The median follow-up duration was 41.4 months. Patients with sarcopenia were younger and had higher carcinoembryonic antigen levels than patients without sarcopenia. RFS and overall survival (OS) were significantly shorter in patients with sarcopenia than those without (5-year RFS, 56 vs. 79 %, log-rank p = 0.006; 5-year OS, 68 vs. 85 %, log-rank p = 0.015). Multivariate Cox regression analysis revealed that sarcopenia was independently associated with shorter RFS (hazard ratio [HR] 2.176; 95 % confidence interval [CI] 1.200-3.943; p = 0.010) and OS (HR 2.270; 95 % CI 1.147-4.494; p = 0.019). The influence of sarcopenia on patient outcome was modified by age at surgery (p value for interaction = 0.026); sarcopenia was associated with a poor prognosis, especially in young patients (log-rank p < 0.001).
  
  
  CONCLUSIONS
  Sarcopenia negatively impacts survival in patients undergoing curative resection for stage I-III CRC.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan, yuji-miyamoto@live.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Baba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Mayuko
authors.initials: M
authors.lastname: Ohuchi
authors.forename: Ryuma
authors.initials: R
authors.lastname: Tokunaga
authors.forename: Junji
authors.initials: J
authors.lastname: Kurashige
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Hiyoshi
authors.forename: Shiro
authors.initials: S
authors.lastname: Iwagami
authors.forename: Naoya
authors.initials: N
authors.lastname: Yoshida
authors.forename: Megumi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011859:Radiography; D012189:Retrospective Studies; D055948:Sarcopenia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D002272:Carcinoembryonic Antigen