Clinical impact of sarcopenia for overweight or obese patients with colorectal cancer

Abstract

Abstract Background: Sarcopenia, overweight and obesity are all dynamic change of body composition, which may have negative effect on the prognosis for patients with colorectal cancer. The aim of this study was to investigate the predictive role of sarcopenia on the overweight or obese patients with colorectal cancer. Methods: We conducted a study on the population of overweight or obese patients with colorectal cancer who underwent curative surgeries in two centers between 2015 and 2021. They were grouped by the present of sarcopenia. Propensity score match analysis was used to balance the baseline of clinicopathologic characteristics of two groups. Then, the postoperative outcomes were compared between two groups. Independent risk factors were evaluated for complications using univariate and multivariate analysis. Results: Of 827 patients enrolled, 126 patients were matched for analysis. Patients with sarcopenia had higher incidence of total complication and medical complication, higher rate of laparoscopic surgery performed, and higher hospitalization costs. They also had worse overall survival and disease-free survival. Old age (≥65 years, P = 0.012), ASA grade (Ⅲ, P= 0.008), and sarcopenia (P = 0.036) were independent risk factors for total complications. ASA grade (Ⅲ, P = 0.002) and sarcopenia (P = 0.017) were independent risk factors for medical complications. Conclusions: Sarcopenia was prevalent among overweight or obese patients with colorectal cancer and was associated with negative postoperative outcomes. Early recognition of changes of body composition could help surgeons well prepared for surgical treatment for overweight or obese patients.