Surgical Outcome Assessment of Gastrointestinal Malignancies: Opportunity Prediction by Sarcopenia on CT Measurement

Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength which is associated with increased risks such as physical disability, poor quality of life and death. The authors aimed to evaluate the effects of sarcopenia on postoperative outcomes for curative surgeries of gastrointestinal malignancies. Elective patients who were diagnosed as gastric carcinoma, colorectal carcinoma and pancreatic carcinoma were included in the study retrospectively. A single radiologist assessed CT images, taken in the last month before surgery for calculation of total psoas index and Hounsfield units average calculation in order to select sarcopenic patients. Age, ASA (American Society of Anesthesiologists) scores, weight loss, performance status, postoperative complications, and 6 month all-cause mortality were analyzed. A total of 123 eligible patients were analyzed and 46 (37.4%) of them were grouped as sarcopenic. Sarcopenic patients were older, had higher ASA scores, more weight loss, lower performance, and had more life threatening postoperative complications when compared to non-sarcopenic patients. Sarcopenia determined by cancer evaluation CT seems to be an important criterion in determining the surgical complications in gastrointestinal cancer patients. A high-risk patient may be better prepared with the combination of nutrition, physical exercise and neoadjuvant treatment options before surgery.