Sarcopenia and the clinicopathological outcomes in laparoscopic rectal surgery
Affiliation
South Warwickshire University NHS Foundation TrustPublication date
2020-12Subject
Surgery
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Aims: Models for predicting outcomes in rectal cancer surgery are inconsistent and improving their accuracy for individualised care is needed. While radiologically determined sarcopenia (low lean muscle mass) is associated with poorer outcomes from chemoradiotherapy, there were no studies on its effect on minimally invasive surgery. We therefore examined its relationship with the clinicopathological outcomes of laparoscopic rectal cancer resections. Methods: The prospectively accrued database was used to identify rectal cancer resections performed over a 2-year period. Of the 90 rectal cancers patients, 45 underwent laparoscopic resections and the data on clinicopathological features were collected. The CT scans were examined retrospectively to determine their sarcopenia score (graded 1-4), defined by the quartiles of the HUACs (Hounsfield Unit Average Calculation) of the average area of both psoas muscles. Results: Low sarcopenia scores (<2) were associated preoperatively with age (r=0.305, p=0.043), WHO performance status (r=0.479, p<0.001), and type 2 diabetes mellitus (r=0.379, p=0.01). They also correlated postoperatively to Clavien-Dindo Morbidity Scores of 2 or more (r=0.316, p=0.046; OR 1.27, p=0.043), low TME grades (r=-0.316, p=0.046; OR 0.78, p=0.012) and conversion to open surgery (r=0.305, p=0.043; OR 1.61, p=0.049). Conclusions: Sarcopenia is a useful marker in laparoscopic rectal cancer resections and therefore requires further evaluation towards improving model predictions of surgical outcomes.Citation
Yershov D, Zafar S, Sinha R, Francombe J, Andhalgaonkar K, Ramcharan S. Sarcopenia and the clinicopathological outcomes in laparoscopic rectal surgery. Br J Surg. 2020 Dec;107 Suppl 4:29. doi: 10.1002/bjs.12067Type
Conference OutputAdditional Links
https://academic.oup.com/bjs/article/107/Supplement_4/11/6139368Journal
The British Journal of SurgeryPublisher
Oxford University Pressae974a485f413a2113503eed53cd6c53
10.1002/bjs.12067