The Prognostic Role of Sarcopenia in Long-term Outcomes of Colorectal Cancer Pathological Stage III Cases: A Propensity Score-matched Analysis

Abstract

Abstract Background The prognostic role of sarcopenia for colorectal cancer (CRC) surgery remains controversial. We evaluated the prognostic role of sarcopenia in patients with pathological Stage III (pStage III) CRC. Methods We retrospectively examined 113 patients with pStage III CRC who underwent curative resection. We assessed sarcopenia based on a decrease in muscle mass; specifically, the cross-sectional area of the skeletal muscle at the level of the third lumbar vertebra was measured using computed tomography, and low values were defined as sarcopenia. The effects of sarcopenia on overall survival (OS) and recurrence-free survival (RFS) were investigated. The propensity score matching method was used to adjust for patient background. Results Of the 113 cases, 10 were excluded owing to lack of information, and 103 cases were analyzed. Of 103 patients, 67 (65.0%) had sarcopenia. Patients in the sarcopenia group were predominantly female and had a high number of right-sided lesions. Using propensity score matching, the sarcopenia and control groups were matched in 33 patients, and sex and tumor location were almost equal between the groups. Postoperative hospital stay was significantly longer in the sarcopenia group than in the non-sarcopenia group (median, 15 days vs. 10 days; p = 0.020). The sarcopenia group had significantly worse OS (5-year: 64.0% vs. 90.9%; hazard ratio, 4.870; 95% confidence interval, 1.371–17.306; p = 0.007) and RFS (5-year: 52.1% vs. 78.8%; hazard ratio, 2.654; 95% confidence interval, 1.078–6.537; p = 0.027) than the non-sarcopenia group. Conclusions Sarcopenia is a poor prognostic factor for both OS and RFS in patients with pStage III CRC.