Preoperative sarcopenia predicts survival after hepatectomy for colorectal metastases: A prospective observational study

OBJECTIVE: The surgical approach to colorectal liver metastases has highly improved the survival rates in metastatic colorectal cancer patients. Since sarcopenia estimates the physiologic reserve of an individual patient, it is considered a surrogate marker of patient frailty, and the selection of appropriate candidates for LR could be crucial to maximize the benefits derived from surgery. The present study investigated the impact of sarcopenia as a prognostic factor after LR from CRLM. PATIENTS AND METHODS: The study retrospectively analyzed 74 patients. Skeletal Muscle Mass at the third lumbar vertebra in the inferior direction was quantified using enhanced computed tomography scans. The patients were divided into two subgroups, with and without sarcopenia, based on median Skeletal Muscle Index. RESULTS: The study included 48 Sarcopenic patients and 26 Non Sarcopenic patients. The median follow-up considered for the patients was 32 months. Median SMI was 39.3 and 52.7 cm2/m2, respectively. The OS rate was significantly different between the two groups. Preoperative sarcopenia resulted in worse OS up to 48 months. CONCLUSIONS: Sarcopenia represents a negative prognostic factor as it is associated with poor postoperative OS. Future programs focused on remediating to the preoperative sarcopenic status of colorectal liver metastatic patients should be implemented.