The correlation between sarcopenia and long-term prognosis of elderly patients with local advanced colorectal cancer
Objective To investigate the relationship between sarcopenia and the long-term prognosis of elderly patients with locally advanced colorectal cancer.Methods A retrospective analysis was conducted on clinical data from 205 elderly colorectal cancer patients aged 70 years and above who underwent radical resection with TNM staging of stage Ⅱ to Ⅲ at Beijing Hospital between January 2014 and December 2018.The study utilized abdominal CT scans taken within 30 days before surgery to measure the skeletal muscle area(SMA)of the 3rd lumbar vertebrae cross-section.Sarcopenia was defined as a skeletal muscle index(SMI)of ≤52.4 cm2/m2 in men and≤38.5 cm2/m2 in women(SMI=SMA/height2).A comparison was made between the clinical and pathological conditions of patients with and without sarcopenia in the two groups,with an analysis of the impact of sarcopenia on the long-term prognosis of elderly postoperative colorectal cancer patients.Results Among the 205 patients assessed,63.4％(130/205)were diagnosed with sarcopenia.The group with sarcopenia had a higher percentage of individuals aged 80 years and older(x2=6.420,P=0.011)compared to those without sarcopenia.Additionally,this group had a lower proportion of overweight or obese patients(x2=9.366,P=0.009),fewer patients who underwent adjuvant chemotherapy,and a lower 5-year disease-free survival rate post-surgery(x2=6.257,7.347,P=0.012,0.007).Kaplan-Meier analysis indicated that disease-free survival rate was better in elderly patients with locally advanced colorectal cancer who did not have sarcopenia compared to those with sarcopenia(Log-rank x2=6.919,P=0.009).Moreover,in elderly patients without sarcopenia,those who received adjuvant chemotherapy had a more favorable disease-free survival outcome than those who did not receive such treatment(Log-rank x2=4.745,P=0.029).Multifactorial Cox regression analysis showed that TNM stage Ⅲ(HR=1.634,95％CI:1.110-2.404,P=0.013)and the presence of sarcopenia(HR=1.509,95％CI:1.017-2.238,P=0.041)were significant factors influencing the poor long-term prognosis of elderly patients with locally advanced colorectal cancer.Conclusions Sarcopenia is associated with aging and body mass index,and has been found to be a significant factor in the long-term prognosis of elderly colorectal cancer patients.Those with sarcopenia tend to have a poorer prognosis,while those without may experience benefits from adjuvant chemotherapy.
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