Psoas Muscle Cross-Sectional Area and Outcomes Following Colorectal Cancer Surgery
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Abstract
Background: Frailty and functional status are established risk factors for postoperative morbidity
and mortality, but new data also suggest a link between sarcopenia and longer-term oncological
outcomes in colorectal cancer. Cross-sectional imaging is performed routinely prior to elective
resection and provides a means to measure psoas muscle cross-sectional area, which in turn is a
surrogate marker of sarcopenia.
Methods: A retrospective cohort study of patients undergoing elective surgery with curative intent
for colorectal cancer. Using automated software, psoas muscle cross-sectional area was measured
and the relationship with five-year disease-free survival was evaluated using Kaplan-Meier survival
curves.
Results: A significant relationship was found among patients with a low (below median) psoas
muscle cross-sectional area, HR 1.57 (95% CI 1.1-2.5) p=0.04.
Conclusion: This study demonstrated a potential relationship between psoas muscle crosssectional area and disease-free survival, highlighting the further utility of pre-operative staging
CT in predicting prognosis in patients with colorectal cancer.
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References
REFERENCES:
Robinson TN, Wu DS, Pointer L, Dunn CL, Cleveland JC, Moss M. Simple frailty score predicts postoperative complications across surgical specialties. Am J Surg. 2013; 206(4): 544-550.
Fagard K, Leonard S, Deschodt M et al. The impact of frailty on postoperative outcomes in individuals aged 65 and over undergoing elective surgery for colorectal cancer: A systematic review. Journal of Geriatric Oncology 2016; 7(6): 479–491.
Makary MA, Segev DL, Pronovost PJ et al. Frailty as a Predictor of Surgical Outcomes in Older Patients. Journal of the American College of Surgeons 2010; 210(6): 901–908.
Garg L, Agrawal S, Pew T et al. Psoas Muscle Area as a Predictor of Outcomes in Transcatheter Aortic Valve Implantation. The American Journal of Cardiology 2017; 119(3), 457–460.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. The Lancet 2013; 381(9868): 752–762.
Lieffers JR, Bathe OF, Fassbender K, Winget M, Baracos VE. Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery. British Journal of Cancer 2012; 107(6): 931–936.
Peng PD, van Vledder MG, Tsai S et al. Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis. HPB 2011; 13(7): 439–446.
Boutin RD, Yao L, Canter RJ, Lenchik L. Sarcopenia: Current Concepts and Imaging Implications. American Journal of Roentgenology 2015; 205(3): W255–W266.
Jones KI, Doleman B, Scott S, Lund JN, Williams JP. Simple psoas cross-sectional area measurement is a quick and easy method to assess sarcopenia and predicts major surgical complications. Colorectal Disease 2015; 17(1): O20–O26.
Miller AL, Englesbe MJ, Diehl KM et al. Preoperative Psoas Muscle Size Predicts Postoperative Delirium in Older Adults Undergoing Surgery: A Pilot Cohort Study. Journal of the American Geriatrics Society 2017; 65(1): e23–e24.
Reisinger KW, A van Vugt JL, W Tegels JJ et al. Functional Compromise Reflected by Sarcopenia, Frailty, and Nutritional Depletion Predicts Adverse Postoperative Outcome After Colorectal Cancer Surgery. Ann Surg 2015 Feb; 261(2): 345-52.
McClellan T, Allen BC, Kappus M et al. Repeatability of Computerized Tomography–Based Anthropomorphic Measurements of Frailty in Patients With Pulmonary Fibrosis Undergoing Lung Transplantation. Current Problems in Diagnostic Radiology 2017; 46(4): 300–304.
New Zealand Guidelines Group. Guidance on surveillance for people at increased risk of colorectal cancer [PDF on Internet]. Wellington: New Zealand Guidelines Group [Updated 2011]. Available from: https://www.health.govt.nz/system/files/documents/publications/colorectal-cancer-surveillance-guidance.pdf
Birgisson H, Wallin U, Holmberg L, Glimelius B. Survival endpoints in colorectal cancer and the effect of second primary other cancer on disease free survival. BMC cancer. 2011; 11(1): 438.
Prado CMM, Lieffers JR, McCargar LJ et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. The Lancet. Oncology 2008; 9(7): 629–635.
Fearon K, Strasser F, Anker SD et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011; 12(5): 489-95.
Park SY, Yoon JK, Lee SJ, Haam S, Jung J. Prognostic value of preoperative total psoas muscle area on long-term outcome in surgically treated oesophageal cancer patients. Interact Cardiovasc Thorac Surg. 2017; 24(1): 13-9.
Hanaoka M, Yasuno M, Ishiguro M et al. Morphologic change of the psoas muscle as a surrogate marker of sarcopenia and predictor of complications after colorectal cancer surgery. Int J Colorectal Dis. 2017; 32(6): 847-56.