Psoas density - an optimal sarcopaenic indicator associated with postoperative complications after colorectal resection for cancer?

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Authors

PEKAŘOVÁ Anna PEKAŘ Matej SOLTES Marek HAVRLENTOVA Lucia CHOVANCOVA Tereza

Year of publication 2021
Type Article in Periodical
Magazine / Source VIDEOSURGERY AND OTHER MINIINVASIVE TECHNIQUES
MU Faculty or unit

Faculty of Medicine

Citation
Web https://doi.org/10.5114/wiitm.2020.100880
Doi http://dx.doi.org/10.5114/wiitm.2020.100880
Keywords complications; colorectal cancer; computed tomography; sarcopaenia; psoas density
Description 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 postop- erative 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 sin- gle 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 preop- erative staging CT scan, it might be considered an optimal sarcopaenic indicator to be utilised in everyday practice.
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