title: Prevalence of sarcopenia in older patients with colorectal cancer.
abstract: OBJECTIVE
  Sarcopenia is the age-related loss of muscle mass, strength, and function. It is a common finding in older patients and is associated with decreased life expectancy and potentially higher susceptibility to chemotherapy toxicity. This study describes the prevalence of sarcopenia in older adults with early stage colorectal cancer.
  
  
  METHODS
  Patients ≥70 years old who underwent surgical resection for stage I-III colorectal cancer between 2008 and 2013 were identified from the medical record. Sarcopenia was assessed by measuring the total muscle area on computerized tomography (CT) images obtained prior to surgery. Total muscle area was measured at the level of L3 and normalized using each patient's height to produce a skeletal muscle index (SMI). Sarcopenia was defined using sex- and body mass index (BMI)-specific threshold values of SMI.
  
  
  RESULTS
  Eighty-seven patients were included, with a median age of 77 years (70-96). Twenty-five men (60% of 42) and 25 women (56% of 45) had sarcopenia. Sarcopenic patients had significantly lower BMI (p=0.03) compared to non-sarcopenic patients. There was a positive correlation between BMI and SMI for both men (r=0.44) and women (r=0.16).
  
  
  CONCLUSIONS
  Sarcopenia is highly prevalent among older patients with early stage colorectal cancer. BMI alone is a poor indicator of lean body mass and improved methods of screening for sarcopenia are necessary. CT scans are a viable option for identifying sarcopenic patients in whom timely interventions may improve survival, quality of life, and functional outcomes.
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States. Electronic address: james_broughman@med.unc.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Broughman
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States; UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Grant R
authors.initials: GR
authors.lastname: Williams
authors.affiliation: UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States; UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Yu
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States; UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Nyrop
authors.affiliation: UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Shani M
authors.initials: SM
authors.lastname: Alston
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States; UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Brittaney-Belle
authors.initials: BB
authors.lastname: Gordon
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States; UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Hanna K
authors.initials: HK
authors.lastname: Sanoff
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC 27516, United States; UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC 27514, United States.
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009367:Neoplasm Staging; D015995:Prevalence; D011788:Quality of Life; D055948:Sarcopenia / Q000453:epidemiology* / Q000209:etiology; D014057:Tomography, X-Ray Computed
keywords: Cachexia; Colorectal cancer; Older patients; Sarcopenia