Key result
Psoas density was significantly lower in patients with severe postoperative complications compared to mild/no complications after colon (40.11 vs 42.67 HU, p=0.002) and rectal resections.
Why the study?
Sarcopaenia predicts postoperative morbidity and mortality after colorectal resection for cancer, but an ideal sarcopaenic indicator has not been identified.
Does preoperative psoas density predict severe postoperative complications in patients undergoing curative colorectal resection for cancer?
Cohort (n=112)
No
Does preoperative psoas density predict severe postoperative complications in patients undergoing curative colorectal resection for cancer?
p-value: p=0.002 for colon, 0.016 for rectal
Preoperative psoas density measured by CT is a simple and affordable indicator of sarcopenia that predicts severe postoperative complications after colorectal cancer resection.
PD was associated with major complications after colorectal cancer resection; leaves open its role in preoperative risk assessment pending prospective studies.
INTRODUCTION: Sarcopaenia seems to be predictive factor for postoperative morbidity and mortality after colorectal resection for cancer. Nevertheless, an ideal sarcopaenic indicator is still to be identified. AIM: To evaluate computed tomography (CT) measured total abdominal muscle area (TAMA), total psoas muscle area (TPA), and psoas density (PD) - previously described sarcopaenia indicators - as possible risk factors for postoperative complications in patients after curative colon and rectal resections for colorectal cancer. MATERIAL AND METHODS: Consecutive patients after elective curative colon or rectal resection for cancer at a single institution were divided into cohorts with uncomplicated postoperative course or complications Clavien-Dindo grade I-II (Cl-Di 0-II) and complications Clavien-Dindo grade III-V (Cl-Di III-V). Cohorts were statistically tested for significant differences in TAMA, TPA, and PD calculated from preoperative staging CT scans at the level of the third lumbar vertebra. RESULTS: Data of 112 patients were analysed from a prospectively run database; 65 underwent colon and 47 rectal resections. PD was significantly higher in the Cl-Di 0-II cohort compared to the Cl-Di III-V for both colon (42.67 ±6.52 vs. 40.11 ±7.57 HU, p = 0.002) and rectal resections (44.08 ±5.86 vs. 43.03 ±5.70HU, p = 0.016). TAMA and TPA failed to show significant differences. CONCLUSIONS: Psoas density is significantly decreased in patients with Clavien-Dindo grade III-V complications after curative resection for colon and rectal cancer. Due to the simplicity and affordability of its assessment from preoperative staging CT scan, it might be considered an optimal sarcopaenic indicator to be utilised in everyday practice.
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Pekařová et al. (2020) conducted a cohort in Colorectal cancer (n=112). Psoas density vs. Uncomplicated or mild complications (Clavien-Dindo 0-II) was evaluated on Postoperative complications (Clavien-Dindo grade III-V) (p=0.002 for colon, 0.016 for rectal). Psoas density was significantly lower in patients with severe postoperative complications compared to mild/no complications after colon (40.11 vs 42.67 HU, p=0.002) and rectal resections.
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