Cited by 139Nutrition and Health in AgingColorectal Cancer Surgical TreatmentsBody Composition Measurement Techniques

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Assessment of Computed Tomography (CT)-Defined Muscle and Adipose Tissue Features in Relation to Short-Term Outcomes After Elective Surgery for Colorectal Cancer: A Multicenter Approach

Martin, Lisa, Hopkins, Jessica, Malietzis, Georgios, Jenkins, J. T., Sawyer, Michael B., Brisebois, Ron, MacLean, Anthony, Nelson, Gregg, Gramlich, Leah, Baracos, Vickie E.·2018·Annals of Surgical Oncology

DOI 10.1245/s10434-018-6652-x

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Abstract

Background Sarcopenia, visceral obesity (VO), and reduced muscle radiodensity (myosteatosis) are suggested risk factors for postoperative morbidity in colorectal cancer (CRC), but usually are not concurrently assessed. Published thresholds used to define these features are not CRC-specific and are defined in relation to mortality, not postoperative outcomes. This study aimed to evaluate body composition in relation to length of hospital stay (LOS) and postoperative outcomes.Methods Pre-surgical computed tomography (CT) images were assessed for total area and radiodensity of skeletal muscle and visceral adipose tissue in a pooled Canadian and UK cohort (n = 2100). Sex- and age-specific values for these features were calculated. For 1139 of 2100 patients, LOS data were available, and sex- and age-specific thresholds for sarcopenia, myosteatosis, and VO were defined on the basis of LOS. Association of CT-defined features with LOS and readmissions was explored using negative binomial and logistic regression models, respectively.Results In the multivariable analysis, the predictors of LOS (P < 0.001) were age, surgical approach, major complications (incidence rate ratio [IRR] 2.42; 95% confidence interval [CI] 2.18-2.68), study cohort, and three body composition profiles characterized by myosteatosis combined with either sarcopenia (IRR, 1.27; 95% CI 1.12-1.43) or VO (IRR, 1.25; 95% CI 1.10-1.42), and myosteatosis combined with both sarcopenia and VO (IRR, 1.58; 95% CI 1.29-1.93). In the multivariable analysis, risk of readmission was associated with VO alone (odds ratio [OR] 2.66; 95% CI 1.18-6.00); P = 0.018), VO combined with myosteatosis (OR, 2.72; 95% CI 1.36-5.46; P = 0.005), or VO combined with myosteatosis and sarcopenia (OR, 2.98; 95% CI 1.06-5.46; P = 0.038). Importantly, the effect of body composition profiles on LOS and readmission was independent of major complications.Conclusion The findings showed that CT-defined multidimensional body habitus is independently associated with LOS and hospital readmission.

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Authors: Martin, L., Hopkins, J., Malietzis, G., Jenkins, J. T., Sawyer, M. B., Brisebois, R., MacLean, A., Nelson, G., Gramlich, L., & Baracos, V. E.
Affiliations: University of Alberta (CA)
St Mark's Hospital (GB)
University of Calgary (CA)
Corresponding author: Baracos, Vickie E.
ORCID: Martin, Lisa
Hopkins, Jessica
Jenkins, J. T.
Sawyer, Michael B.
MacLean, Anthony
Nelson, Gregg
Gramlich, Leah
Baracos, Vickie E.
Venue: Annals of Surgical Oncology
Publisher: Springer Science and Business Media LLC
Published: 2018-07-13
Volume: 25
Issue: 9
Pages: 2669-2680
ISSN: 1068-9265 (ISSN-L)
1534-4681
DOI: 10.1245/s10434-018-6652-x
OpenAlex: W2884255416
Cited by: 139
References: 59
Citations by year: 2026: 17 · 2025: 11 · 2024: 20 · 2023: 10 · 2022: 24 · 2021: 23 · 2020: 22 · 2019: 11 · 2018: 1
FWCI: 9.84
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Annals of Surgical Oncology (publishedVersion)
PubMed (publishedVersion)
Funders: Alberta Innovates - Health Solutions (Partnership for Research, Innovation in the Hea)
Alberta Health Services (Cancer Strategic Clinical Network Seed Grant)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
Keywords: colorectal cancer, sarcopenia, visceral obesity, myosteatosis, body composition, skeletal muscle radiodensity, visceral adipose tissue, length of hospital stay, postoperative complications, hospital readmission, elective colorectal surgery, preoperative risk assessment, surgical approach, major postoperative complications, risk stratification, prognostic factors
MeSH terms: Adipose Tissue, Aged, Body Composition, Female, Follow-Up Studies, Humans, Male, Patient Readmission, Postoperative Complications, Prognosis, Risk Factors, Tomography, X-Ray Computed, Colorectal Neoplasms, Cohort Studies, Survival Rate, Elective Surgical Procedures, Muscle, Skeletal, Sarcopenia

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Assessment of Computed Tomography (CT)-Defined Muscle and Adipose Tissue Features in Relation to Short-Term Outcomes After Elective Surgery for Colorectal Cancer: A Multicenter Approach

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