CT-derived measures of muscle quantity and quality predict poorer outcomes from elective colorectal surgery: a UK multicentre retrospective cohort study

• DOI: 10.1007/s10151-023-02769-3
• Publication Date: 2023-05-03T10:03:05Z
• Authors: J. E. M. Blackwell; P. J. J. Herrod; B. Doleman; H. Boyd-Carson; D. Dolan; L. Wheldon; S. R. Brown; A. Banerjea; S. Moug; J. N. Lund; ; Michael Wong; Alexander N. C. B...; Ross Sian; Peter Metherall; Jenna Harthorne; Natasha Redhead; Leonie Walker; Fiona Marshall; Christopher G. D....; Paul Thomas; Liam Hyland; Jacob R. Hatt; Edward Hardy; Thomas Smart; James Bunce; Alysha Careless; Yi Lin Lai; Elizabeth Gemmill
• Keywords: Prehabilitation; Univariate analysis; Colorectal Surgery

To assess whether preoperative radiologically defined lean muscle measures are associated with adverse clinical outcomes in patients undergoing elective surgery for colorectal cancer.This retrospective UK-based multicentre data collection study identified having had cancer resection curative intent between January 2013 to December 2016. Preoperative computed-tomography (CT) scans were used measure psoas characteristics. Clinical records provided postoperative morbidity and mortality data.This included 1122 patients. The cohort was separated into a combined group (patients both sarcopenia myosteatosis) others (either or myosteatosis, neither). For the group, anastomotic leak predicted on univariate (OR 4.1, 95% CI 1.43-11.79; p = 0.009) multivariate analysis 4.37, 1.41-13.53; 0.01). Also (up 5 years postoperatively) (HR 2.41, 1.64-3.52; < 0.001) 1.93, 1.28-2.89; 0.002). A strong correlation exists freehand-drawn region of interest-derived density measurement using ellipse tool (R2 81%; 0.001).Measures quality quantity, which predict important outcomes, can be quickly easily taken from routine imaging being considered surgery. As poor mass again shown poorer these should proactively targeted within prehabilitation, perioperative rehabilitation phases minimise negative impact pathological states.