Sarcopenia and primary tumor location influence patients outcome after liver resection for colorectal liver metastases. Issue 3 (March 2022)

• Record Type: Journal Article
• Authors: Bajrić, Tarik; Kornprat, Peter; Faschinger, Florian; Werkgartner, Georg; Mischinger, Hans Jörg; Wagner, Doris
• Is Part Of: European journal of surgical oncology. Volume 48:Issue 3(2022)
• Page Start: 615
• Page End: 620
• Publication Date: 2022-03
• Subjects: Colorectal cancer -- Colorectal liver metastases -- Liver surgery -- Sarcopenia -- Cachexia -- Primary tumor localization -- Left sided colorectal cancer -- Right sided colorectal cancer; CRC colorectal carcinoma -- CRLM colorectal liver metastasis -- PTL primary tumor location -- SMI skeletal muscle index -- HR Hazard Ratio -- OR Odds Ratio -- CI confidence interval; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2021.09.010
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Introduction: Right-sided and left-sided colorectal cancer (CRC) is known to differ in their molecular carcinogenic pathways. The prevalence of sarcopenia is known to worsen the outcome after hepatic resection. We sought to investigate the prevalence of sarcopenia and its prognostic application according to the primary CRC tumor site. Methods: 355 patients (62% male) who underwent liver resection in our center were identified. Clinicopathologic characteristics and long-term outcomes were stratified by sarcopenia and primary tumor location (right-sided vs. left-sided). Tumors in the coecum, right sided and transverse colon were defined as right-sided, tumors in the left colon and rectum were defined as left-sided. Sarcopenia was assessed using the skeletal muscle index (SMI) with a measurement of the skeletal muscle area at the level L3. Results: Patients who underwent right sided colectomy (n = 233, 65%) showed a higher prevalence of sarcopenia (35.2% vs. 23.9%, p = 0.03). These patients also had higher chances for postoperative complications with Clavien Dindo >3 (OR 1.21 CI95% 0.9–1.81, p = 0.05) and higher odds for mortality related to CRC (HR 1.2 CI95% 0.8–1.8, p = 0.03).On multivariable analysis prevalence of sarcopenia remained independently associated with worse overall survival and disease free survival (overall survival: HR 1.47 CI 95% 1.03–2.46, p = 0.03; HR 1.74 CI95% 1.09–3.4, p = 0.05 respectively). Conclusion: Sarcopenia is known to have a worse prognosis in patients with CRLM and CRC. Depending on the primary location sarcopenia has a variable effect on the outcome after liver resection.