THE FEATURES OF PREOPERATIVE MYOPENIA, MYOSTEATOSIS, AND PHYSICAL FUNCTION IN JAPANESE PATIENTS WITH GASTROINTESTINAL CANCER: A CROSS-SECTIONAL STUDY

Abstract

Background A preoperative intervention called “prehabilitation” has become increasingly important to prevent postoperative complications. Prescribing tailor-made programs according to patient characteristics is essential to enhance the benefits of this intervention. However, data on the physical characteristics of preoperative gastrointestinal cancer patients with myopenia or myosteatosis are lacking, especially for Asian individuals. This study aimed to determine the characteristics of physical function in preoperative gastrointestinal cancer patients with skeletal muscle abnormalities. Materials and Methods This single-center cross-sectional study included patients who underwent open or laparoscopic surgery for primary colorectal or gastric cancer between October 2016 and August 2020. Skeletal muscle mass and density were measured using preoperative computed tomography images at the level of the third lumbar vertebra. Skeletal muscle abnormalities (myopenia / myosteatosis) were defined using sex- and age-specific thresholds based on previous studies. The assessment of preoperative physical function included handgrip strength, isometric knee-extensor muscle force, and 6-minute walking distance. Patients were divided into the following four groups; 1) normal group; 2) myopenia / non-myosteatosis group; 3) non-myopenia / myosteatosis group; 4) myopenia / myosteatosis group. Preoperative physical functions were compared between the normal and other groups. Results Overall, 126 patients with a median age of 69 years were included in the analysis. The prevalence of myopenia and myosteatosis in the patients was 63% and 52%, respectively. Patients with both skeletal muscle abnormalities (myopenia and myosteatosis) had poorer physical function than normal patients. Conclusions More than half of the Japanese preoperative patients with gastrointestinal cancer had either myopenia or myosteatosis, and the patients with both myopenia and myosteatosis were considered as a “high risk for severe sarcopenia” population. This information can be used to prescribe an optimal, customized treatment to preoperative patients with gastrointestinal cancer.

Keywords

• myopenia
• myosteatosis
• physical function
• preoperative gastrointestinal cancer