Impact of preoperative subcutaneous adipose, visceral adipose and skeletal muscle on the outcomes of the oldest-old colorectal cancer patients after surgery

Jinxin Shi; Jian Cui; Wenrui Xu; Zhexue Wang; Junge Bai; Zijian Li; Fuhai Ma; Tianming Ma; Ju Cui; Guoju Wu; Gang Zhao; Qi An

Clinical Surgical Oncology (Mar 2024)

Impact of preoperative subcutaneous adipose, visceral adipose and skeletal muscle on the outcomes of the oldest-old colorectal cancer patients after surgery

Jinxin Shi,
Jian Cui,
Wenrui Xu,
Zhexue Wang,
Junge Bai,
Zijian Li,
Fuhai Ma,
Tianming Ma,
Ju Cui,
Guoju Wu,
Gang Zhao,
Qi An

Affiliations

Jinxin Shi: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Jian Cui: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Wenrui Xu: Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Zhexue Wang: Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, China
Junge Bai: Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, China
Zijian Li: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Fuhai Ma: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Tianming Ma: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Ju Cui: The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, China
Guoju Wu: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Gang Zhao: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
Qi An: Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Corresponding author.

Journal volume & issue: Vol. 3, no. 1
p. 100036

Abstract

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Background: Colorectal cancer (CRC) is one of the most common tumors worldwide, with rising numbers of elderly patients affected. Nutritional status significantly influences tumor prognosis. We aimed to investigate the association of subcutaneous and visceral adipose tissue and skeletal muscle mass with the prognosis of the oldest-old patients with CRC, after surgery. Patients: We retrospectively reviewed 210 patients >75 years who underwent surgical treatment at the Department of Gastrointestinal Surgery, Beijing Hospital, between December 2010 and December 2020. Materials: Subcutaneous adipose, visceral adipose, and skeletal muscle areas were measured using BMI_CT. The cut-off values of the CT measurements were then confirmed using receiver operating characteristic (ROC) curve analysis. Results: Subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), and total adipose tissue index (TATI) were significantly associated with sex and BMI. Notably, the oldest-old CRC patients with high SATI, VATI, and TATI scores exhibited significantly higher rates of wound complications and reduced postoperative hospitalization durations. Intriguingly, patients with high VATI and TATI demonstrated significantly better 5-year Overall survival (OS), Cancer-specific survival (CSS), and Disease-free survival (DFS) than patients in the other groups. Similar results were observed in patients with a high visceral-to-subcutaneous fat ratio (VSR) and skeletal muscle index (SMI) scores. Conclusion: Significantly improving skeletal muscle content while concurrently managing the total adipose content, especially visceral adipose tissue, may aid in extending the survival time of oldest-old patients with CRC after surgery.

Published in Clinical Surgical Oncology

ISSN: 2773-160X (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.sciencedirect.com/journal/clinical-surgical-oncology

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