Prognostic Significance of Sarcopenia in Patients with Esophagogastric Junction Cancer or Upper Gastric Cancer Sarcopenia: Prevalence, and Impact on Operative and Oncologic Outcomes in the Multimodal Management of Locally Advanced Esophageal Cancer Impact of Visceral Obesity and Sarcopenia on Short-Term Outcomes After Colorectal Cancer Surgery Sarcopenia in ovarian cancer patients, oncologic outcomes revealing the importance of clinical nutrition: review of literature. Sarcopenia Adversely Impacts Postoperative Clinical Outcomes Following Gastrectomy in Patients with Gastric Cancer: A Prospective Study Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy. The influence of sarcopenia on survival and surgical complications in ovarian cancer patients undergoing primary debulking surgery. Impact of different sarcopenia stages on the postoperative outcomes after radical gastrectomy for gastric cancer Sarcopenia in overweight and obese patients is a predictive factor for postoperative complication in gastric cancer: A prospective study. Sarcopenia in Advanced Serous Ovarian Cancer Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer Sarcopenia predicts 1-year mortality in elderly patients undergoing curative gastrectomy for gastric cancer: a prospective study Value of sarcopenia assessed by computed tomography for the prediction of postoperative morbidity following oncological colorectal resection: A comparison with the malnutrition screening tool. Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery. Sarcopenia is Associated with Chemotherapy Toxicity in Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Colorectal Cancer A Novel Nomogram for Predicting Postsurgical Intra-abdominal Infection in Gastric Cancer Patients: a Prospective Study Computed tomography diagnosed cachexia and sarcopenia in 725 oncology patients: is nutritional screening capturing hidden malnutrition?
Background The association between sarcopenia and postoperative outcomes for patients with gastrointestinal malignancies remains controversial . This study aim ed to assess the impact of sarcopenia on short- and long-term outcomes after surgery for esophagogastric junction cancer ( EGJC ) or upper gastric cancer ( UGC ) . Methods The study review ed 148 patients with EGJC or UGC who underwent surgical resection .  The patients were categorized into the sarcopenia group or the non-sarcopenia group according to their skeletal muscle index calculated using abdominal computed tomography images . The study compared clinicopathologic factors , postoperative complications , and prognosis between the two groups . Results Sarcopenia was present in 19 patients ( 32.2 % ) with EGJC and 23 patients ( 25.8 % ) with UGC . The 5-year overall survival ( OS ) and recurrence-free survival ( RFS ) rates were significantly poorer in the sarcopenia group than in the non-sarcopenia group ( OS 85.5 vs 54.8 % , P = 0.0010 ; RFS 78.7 vs 51.7 % , P = 0.0054 ) . The development of postoperative complications did not differ significantly between the two groups . Both the uni- and multivariate analyses showed that N stage ( P < 0.0001 ) and sarcopenia ( P = 0.0024 and 0.0293 , respectively ) were independent poor prognostic factors for OS . Conclusions Sarcopenia was strongly associated with a poor long-term prognosis for patients with EGJC or UGC who underwent surgery . The results suggest that special attention might be needed during the development of treatment strategies for patients with sarcopenia who intend to undergo operations for EGJC and UGC Objective : The aim of this article was to study the prevalence and significance of sarcopenia in the multimodal management of locally advanced esophageal cancer ( LAEC ) , and to assess its independent impact on operative and oncologic outcomes . Summary of Background Data : Sarcopenia in cancer may confer negative outcomes , but its prevalence and impact on modern multimodal regimens for LAEC have not been systematic ally studied . Methods : Two hundred fifty-two consecutive patients were studied .  Lean body mass ( LBM ) , skeletal muscle index ( SMI ) , and fat mass ( FM ) were determined pre-treatment , preoperatively , and 1 year postoperatively . Sarcopenia was defined by computed tomography ( CT ) at L3 as SMI < 52.4 cm2/m2 for males and SMI < 38.5 cm2/m2 for females . All complications were recorded prospect ively , including comprehensive complications index ( CCI ) , Clavien-Dindo complication ( CDC ) , and pulmonary complications ( PPCs ) . Multivariable linear , logistic , and Cox regression analysis was performed . Results : In-hospital mortality was 1 % , and CCI was 21 ± 19 . Sarcopenia increased ( P = 0.02 ) from 16 % at diagnosis to 31 % post-neoadjuvant therapy , with loss of LBM ( -3.0 ± 5.4 kg , P < 0.0001 ) , but not FM ( -0.3 ± 2.7 kg , P= 0.31 ) during treatment . On multivariable analysis , preoperative sarcopenia was associated with CCI ( P = 0.043 ) , and CDC ≥IIIb ( P = 0.003 ) . PPCs occurred in 36 % nonsarcopenic versus 55 % sarcopenic patients ( P = 0.01 ) . Sarcopenia did not impact disease-specific ( P = 0.14 ) or overall survival ( P = 0.11 ) after resection . At 1 year , 35 % had sarcopenia , significantly associated with pre-treatment BMI ( P = 0.013 ) but not complications ( P = 0.20 ) . Conclusions : Sarcopenia increases through multimodal therapy , is associated with an increased risk of major postoperative complications , and is prevalent in survivorship . These data highlight a potentially modifiable marker of risk that should be assessed and targeted in modern multimodal care pathways Background With the increased prevalence of obesity and sarcopenia , those patients with both visceral obesity and sarcopenia were at higher risk of adverse outcomes . Aim The aim of this study was to ascertain the combined impact of visceral obesity and sarcopenia on short-term outcomes in patients undergoing colorectal cancer surgery . Methods We conducted a prospect i ve study from July 2014 to February 2017 . Patients ’ demographic , clinical characteristics , physical performance , and postoperative short-term outcomes were collected . Patients were classified into four groups according to the presence of sarcopenia or visceral obesity . Clinical variables were compared . Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed . Results A total of 376 patients were included ; 50.8 and 24.5 % of the patients were identified as having “ visceral obesity ” and “ sarcopenia , ” respectively . Patients with sarcopenia and visceral obesity had the highest incidence of total , surgical , and medical complications . Patients with sarcopenia or/ and visceral obesity all had longer hospital stays and higher hospitalization costs . Age ≥ 65 years , visceral obesity , and sarcopenia were independent risk factors for total complications . Rectal cancer and visceral obesity were independent risk factors for surgical complications . Age ≥ 65 years and sarcopenia were independent risk factors for medical complications .  Laparoscopy-assisted operation was a protective factor for total and medical complications . Conclusion Patients with both visceral obesity and sarcopenia had a higher complication rate after colorectal cancer surgery . Age ≥ 65 years , visceral obesity , and sarcopenia were independent risk factors for total complications . Laparoscopy-assisted operation was a protective factor INTRODUCTION Ovarian cancer is the leading cause of death among gynecological malignancies . Its usual clinical manifestation is at advanced stages , with nutritional impairment , weight loss , and a consequent decline in skeletal muscle mass and strength ( defined as sarcopenia ) . The relationship between sarcopenia and decreased survival was demonstrated not only in ovarian cancer but also in other cancer types , such as hepatocellular , pancreatic , lung , colon , cervical , metastatic breast , and renal cancer . The aim of this study is to review the current evidence regarding the relationship between sarcopenia and the surgical and oncological outcomes in ovarian cancer patients . METHODS The systematic search was performed according to the Preferred Reporting Items for Systematic Review s and Meta-Analyses ( PRSIMA ) statement . The terms " SARCOPENIA " AND " OVARIAN CANCER " were systematic ally used to search PubMed and Scopus data bases . Original reports in English language were identified , with the purpose to include all relevant papers regarding the role of sarcopenia and indicators of skeletal muscle quality assessment in gynecological ovarian cancer . RESULTS A total of 9 studies were considered eligible for the present review . The strength of recommendation was moderate and the level of evidence was low in all selected articles . No prospect i ve studies were conducted and most of the papers were case-control series comparing ovarian cancer sarcopenic population vs. non sarcopenic population . CONCLUSIONS Sarcopenia appears to have an important role in oncological outcomes of ovarian cancer patients . However , sarcopenia occurrence during disease history and mechanisms underlying the possible impairment in prognosis should be better investigated . Prospect i ve trials are awaited in order to obtain a better insight in this topic Background Sarcopenia is characterized by decreased skeletal muscle plus low muscle strength and /or physical performance . This study was performed to determine the association of sarcopenia with short-term postoperative outcomes after gastrectomy for gastric cancer . Methods We conducted a prospect i ve study of 255 consecutive patients with gastric cancer who underwent curative gastrectomy .  The sarcopenia elements , including lumbar skeletal muscle index , h and grip strength , and gait speed , were measured before surgery . Patients were followed up after gastrectomy to gain the actual clinical outcomes . Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis . Results Sarcopenia was present in 32 of 255 patients ( 12.5 % ) , and was significantly correlated with advance age , lower body mass index , higher nutritional risk screening ( NRS ) 2002 score , and lower preoperative serum albumin and hemoglobin . Compared with non-sarcopenic patients , sarcopenic patients had a higher risk of postoperative complications , longer postoperative hospital stay , and more hospital costs . In univariate analysis , sarcopenia ( p < 0.001 ) , nutritional risk ( NRS 2002 score ≥3 ; p = 0.003 ) , advanced age ( ≥75 years ; p = 0.014 ) , anemia ( p = 0.012 ) , hypoalbuminemia ( p = 0.029 ) , and diabetes ( p = 0.014 ) were associated with postoperative complications . Multivariable analysis revealed that sarcopenia ( p < 0.001 ) and diabetes ( p = 0.006 ) were independent predictors of postoperative complications . Conclusions Sarcopenia is an independent predictor of postoperative complications in patients with gastric cancer after gastrectomy BACKGROUND A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer . However , the current geriatric assessment has been considered to be either time-consuming or subjective . The present study aim ed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy . MATERIAL S AND METHODS We conducted a prospect i ve study of patients who underwent radical gastrectomy from August 2014 to December 2015 .  Computed tomography-assessed lumbar skeletal muscle , h and grip strength , and gait speed were measured to define sarcopenia . RESULTS Sarcopenia was present in 69 of 240 patients ( 28.8 % ) and was associated with lower body mass index , lower serum albumin , lower hemoglobin , and higher nutritional risk screening 2002 scores . Postoperative complications significantly increased in the sarcopenic patients ( 49.3 % versus 24.6 % , P < 0.001 ) , compared with nonsarcopenic patients . The multivariate analysis demonstrated that sarcopenia ( odds ratio : 2.959 , 95 % CI : 1.629 - 5.373 , P < 0.001 ) and the Charlson comorbidity index ≥2 ( odds ratio : 3.357 , 95 % CI : 1.144 - 9.848 , P = 0.027 ) were independent risk factors for postoperative complications . CONCLUSIONS Sarcopenia , presented as a new geriatric assessment factor , was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer BACKGROUND Sarcopenia , severe skeletal muscle loss , has been identified as a prognostic factor in various malignancies . This study aims to investigate whether sarcopenia is associated with overall survival ( OS ) and surgical complications in patients with advanced ovarian cancer undergoing primary debulking surgery ( PDS ) .  METHODS Ovarian cancer patients ( n = 216 ) treated with PDS were enrolled retrospectively .  Total skeletal muscle surface area was measured on axial computed tomography at the level of the third lumbar vertebra . Optimum stratification was used to find the optimal skeletal muscle index cut-off to define sarcopenia ( ≤38.73 cm2/m2 ) . Cox-regression and Kaplan-Meier analysis were used to analyse the relationship between sarcopenia and OS . The effect of sarcopenia on the development of major surgical complications was studied with logistic regression . RESULTS Kaplan-Meier analysis showed a significant survival disadvantage for patients with sarcopenia compared to patients without sarcopenia ( p = 0.010 ) . Sarcopenia univariably predicted OS ( HR 1.536 ( 95 % CI 1.105 - 2.134 ) , p = 0.011 ) but was not significant in multivariable Cox-regression analysis ( HR 1.362 ( 95 % CI 0.968 - 1.916 ) , p = 0.076 ) . Significant predictors for OS in multivariable Cox-regression analysis were complete PDS , treatment in a specialised centre and the development of major complications . Sarcopenia was not predictive of major complications . CONCLUSION Sarcopenia was not predictive of OS or major complications in ovarian cancer patients undergoing primary debulking surgery . However a strong trend towards a survival disadvantage for patients with sarcopenia was seen . Future prospect i ve studies should focus on interventions to prevent or reverse sarcopenia and possibly increase ovarian cancer survival . Complete cytoreduction remains the strongest predictor of ovarian cancer survival Background . The association between sarcopenia and postoperative outcomes has been well reported . However , the impact of different sarcopenia stages on postoperative outcomes has never been investigated . Methods . We conducted a large , prospect i ve study of patients who underwent radical gastrectomy for gastric cancer from August 2014 to December 2015 .  Sarcopenia was staged as “ presarcopenia , ” “ sarcopenia , ” and “ severe sarcopenia ” according to the definition of the European Working Group on Sarcopenia in Older People . Univariate and multivariate analyses evaluating the risk factors for total , surgical , and medical complications were performed . Results . A total of 470 patients were included , in which 20.6 % , 10 % , and 6.8 % of the patients were identified as having “ presarcopenia , ” “ sarcopenia , ” and “ severe sarcopenia  , ” respectively . Postoperative complications , duration of hospital stays , and costs increased with advancing sarcopenia stages . Severe sarcopenia , visceral fat area to total abdominal muscle area ratio , American Society of Anesthesiologists grade III , and tumor located at the cardia were independent risk factors for total complications . Visceral fat area to total abdominal muscle area ratio and tumor located at the cardia were independent risk factors for operative complications . Presarcopenia , sarcopenia , and severe sarcopenia were all identified as independent risk factors for medical complications , as well as age ≥75 years and Charlson Comorbidity Index . Conclusion . Patients had worse  postoperative outcomes after gastric cancer operation with advancing sarcopenia stages . Severe sarcopenia , but not presarcopenia or sarcopenia , was an independent risk factor for total postoperative complications . The 3 sarcopenia stages independently influence medical but not surgical complications . Recognizing sarcopenia stages is important for preoperative risk stratification BACKGROUND Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength . This study aims to explore the prevalence of sarcopenia in overweight and obese gastric cancer ( GC ) patients and figured out the impacts of sarcopenia on the postoperative complication of overweight and obese GC patients . METHODS According to the recommended body-mass index ( BMI ) for Asian population s by WHO , we conducted a prospect i ve study of overweight and obese gastric cancer patients ( BMI ≥ 23 kg/m2 ) under curative gastrectomy from August 2014 to December 2015 . Including  lumbar skeletal muscle index , h and grip strength and gait speed as the sarcopenic components were measured before surgery . Patients were followed up after gastrectomy to gain the actual clinical outcomes . Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis . RESULTS Total of 206 overweight or obese patients were enrolled in this study , 14 patients were diagnosed sarcopenia and were demonstrated having significantly association with higher risk of postoperative complications , higher hospital costs , and higher rate of 30-days readmission compared with the non-sarcopenic ones . On the basis of univariate and multivariate analysis , sarcopenia was an independent risk factor for postoperative complication of overweight and obese patients with gastric cancer ( P = 0.002 ) . CONCLUSION Sarcopenia is an independent predictor of postoperative complications in overweight or obese patients with gastric cancer after radical gastrectomy Objective Cancer cachexia is a paraneoplastic syndrome comprising involuntary weight loss and muscle depletion ( sarcopenia ) . Although weight loss has been associated with poor clinical outcome , there is only limited information on the prevalence and prognostic impact of sarcopenia in ovarian cancer so far . Methods Total skeletal muscle mass was determined by computed tomography image analysis of the third lumbar skeletal muscle cross-sectional area in 128 patients with advanced serous ovarian cancer . Longitudinal change of muscle mass was studied in  209 consecutive computed tomography scans  from 43 patients . Association with survival was determined using Cox proportional hazards model . Results The prevalence of sarcopenia at first diagnosis was 11 % ( 12/105 ; 95 % confidence interval [ CI ] , 6%–20 % ) . Sarcopenic patients had a significantly reduced progression-free ( hazard ratio , 2.64 ; 95 % CI , 1.24–5.64 ; P = 0.012 ) and overall survival ( hazard ratio , 3.17 ; 95 % CI , 1.29–7.80 ; P = 0.012 ) . On multivariable analysis , these prognostic effects remained significant after adjustment for age , International Federation of Gynecology and Obstetrics stage , and postsurgical residual disease . Longitudinal analyses identified both patients with loss and gain of muscle mass . However , change in muscle mass over time was not associated with survival . Conclusions Baseline sarcopenia is a prognostic factor in advanced serous ovarian cancer . Identification of sarcopenic patients and early enrollment in physical or nutritional education programs might thus be a feasible way to improve outcome and should be further evaluated in prospect i ve clinical trials Abstract Currently , the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated . Moreover , the association between sarcopenia and postoperative complications remains controversial . This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer . From December 2008 to April 2013 , the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospect ively . Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis . Skeletal muscle mass was determined by abdominal ( computed tomography ) CT scan , and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification . Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed . A total of 937 patients were included in this study , and 389 ( 41.5 % ) patients were sarcopenic based on the diagnostic cut-off values ( 34.9 cm2/m2 for women and 40.8 cm2/m2 for men ) . Sarcopenia was an independent risk factor for severe postoperative complications ( OR = 3.010 , P < 0.001 ) , but not for total complications . However , sarcopenia did not show significant association with operative mortality . Moreover , sarcopenia was an independent predictor for poorer overall survival ( HR = 1.653 , P < 0.001 ) and disease-free survival ( HR = 1.620 , P < 0.001 ) . Under the adjusted tumor-node-metastasis ( TNM ) stage , sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III , but not in patients with TNM stage I.Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer . Moreover , sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III , but not in patients with TNM stage Purpose One-year mortality is vital for elderly oncologic patients undergoing surgery . Recent studies have demonstrated that sarcopenia can predict outcomes after major abdominal surgeries , but the association of sarcopenia and 1-year mortality has never been investigated in a prospect i ve study . Methods We conducted a prospect i ve study of elderly patients ( ≥65 years ) who underwent curative gastrectomy for gastric cancer from July 2014 to July 2015 . Sarcopenia was determined by the measurements of muscle mass , h and grip strength , and gait speed . Univariate and multivariate analyses were used to identify the risk factors associated with 1-year mortality . Results A total of 173 patients were included , in which 52 ( 30.1 % ) patients were identified as having sarcopenia . Twenty-four ( 13.9 % ) patients died within 1 year of surgery . Multivariate analysis showed that sarcopenia was an independent risk factor for 1-year mortality . Area under the receiver operating characteristic curve demonstrated an increased predictive power for 1-year mortality with the inclusion of sarcopenia , from 0.835 to 0.868 . Solely low muscle mass was not predictive of 1-year mortality in the multivariate analysis . Conclusions Sarcopenia is predictive of 1-year mortality in elderly patients undergoing gastric cancer surgery . The measurement of muscle function is important for sarcopenia as a preoperative assessment tool BACKGROUND Computed tomography ( CT ) can be used for accurate estimation of whole-body muscle mass and muscle density and for detection of sarcopenia . The goal of this study was to evaluate the additional value of CT measured sarcopenia and muscle attenuation alongside the Malnutrition Universal Screening Tool ( MUST ) for the prediction of post-operative morbidity after oncological colorectal resection , whilst correcting for known risk factors . METHODS A prospect i ve cohort study of 80 patients undergoing elective colorectal surgery in the Netherl and s. Patients were screened for nutritional risk upon admission using the MUST . Additionally , preoperative CT scans were used to determine skeletal muscle mass for the detection of sarcopenia and muscle attenuation . Univariate and multivariable analyses were performed to evaluate associations between the MUST , muscle attenuation and sarcopenia on the one h and and post-operative complications measured by the Clavien-Dindo score on the other h and . RESULTS American Society of Anesthesiology-classification ( ASA ) ≥3 , age ≥70 , MUST ≥2 and lower than median muscle attenuation were significantly associated with a higher risk for postoperative complications ( Clavien-Dindo score ≥2 ) ( p ≤ 0.05 ) , whereas sarcopenia was not ( p = 0.59 ) . Multivariate analyses showed that only MUST ≥2 remained significantly associated with postoperative complications when corrected for age ( p = 0.03 , OR 5.8 , 95%CI 1.1 - 29.6 ) , but not when corrected for age ≥70 and ASA ≥3 . Muscle attenuation and sarcopenia were not significantly associated with postoperative complications . CONCLUSION Our results suggest that using CT measured sarcopenia may have only little additional value over the MUST for the prediction of increased short-term post-operative morbidity after oncological colorectal surgery . It also underlines the importance of currently implemented easy-to-use nutritional screening tools ( MUST ) and raises the question of the evaluation of muscle quality versus quantity in body composition imaging . However , further research is needed to investigate the role of sarcopenia for predicting outcome after colorectal surgery , and investigate the role of muscle attenuation measurements for the prediction of muscle function . CATEGORY OF SU BMI SSION : observational study OBJECTIVE To determine the association of sarcopenia with postoperative morbidity and mortality after colorectal surgery . BACKGROUND Functional compromise in elderly colorectal surgical patients is considered as a significant factor of impaired postoperative recovery . Therefore , the predictive value of preoperative functional compromise assessment was investigated . Sarcopenia is a hallmark of functional compromise . METHODS A total of 310 consecutive patients who underwent oncologic colorectal surgery  were included in a prospect i ve digital data base . Sarcopenia was assessed using the L3 muscle index utilizing Osirix on preoperative computed tomography . Groningen Frailty Indicator and Short Nutritional Assessment Question naire scores were used to assess frailty and nutritional compromise . Predictors for anastomotic leakage , sepsis , and mortality were analyzed by logistic regression analysis . RESULTS Age was an independent predictor of mortality [ P = 0.04 ; odds ratio , 1.17 ; 95 % confidence interval ( CI ) , 1.01 - 1.37 ] . Thirty-day/in-hospital mortality rate in sarcopenic patients was 8.8 % versus 0.7 % in nonsarcopenic patients ( P = 0.001 ; odds ratio , 15.5 ; 95 % CI , 2.00 - 120 ) . Sarcopenia was not predictive for anastomotic leakage or sepsis . Combination of high  Short Nutritional Assessment Question naire score , high Groningen Frailty Indicator score , and sarcopenia strongly predicted sepsis ( P = 0.001 ; odds ratio , 25.1 ; 95 % CI , 5.11 - 123 ) , sensitivity , 46 % ; specificity , 97 % ; positive likelihood ratio , 13 ( 95 % CI , 4.4 - 38 ) ; negative likelihood ratio , 0.57 ( 95 % CI , 0.33 - 0.97 ) . CONCLUSIONS Functional compromise in colorectal cancer surgery is associated with adverse postoperative outcome . Assessment of functional compromise by means of a nutritional question naire ( Short Nutritional Assessment Question naire ) , a frailty question naire ( Groningen Frailty Indicator ) , and sarcopenia measurement ( L3 muscle index ) can accurately predict postoperative sepsis Background Despite the positive survival results of cytoreductive surgery ( CRS ) plus hyperthermic intraperitoneal chemotherapy ( HIPEC ) , criticisms have been put forward regarding the safety of this treatment as a result of a high morbidity rate . Muscle depletion ( sarcopenia ) is associated with the occurrence of postoperative complications . The purpose of this study was to determine the association between sarcopenia and postoperative morbidity after  CRS-HIPEC for peritoneal carcinomatosis from colorectal cancer by distinguishing the complications linked to CRS itself and those associated with chemotherapy ( HIPEC ) toxicities . Methods Data concerning 97 consecutive patients who had undergone CRS-HIPEC were recorded . We analyzed the events occurring within 30 days after surgery that were prospect ively recorded in a data base . Sarcopenia was assessed using the L3 muscle index on computed tomography performed during the 2 months preceding surgery . Results The sarcopenic patients experienced significantly more chemotherapy toxicities ( 57 vs. 26 % ; p = 0.004 ) and especially neutropenia ( 36 vs. 17 % ; p = 0.04 ) than their nonsarcopenic counterparts . There was no difference in complications linked to the CRS procedure between sarcopenic and nonsarcopenic patients . In the multivariate analysis , sarcopenia was the only parameter independently associated with the risk of chemotherapy toxicity ( odds ratio 3.97 ; 95 % confidence interval 1.52–10.39 ; p = 0.005 ) . Conclusions Despite the local administration of chemotherapy , systemic toxicity was observed in sarcopenic patients after CRS-HIPEC . This relationship favors new treatment strategies with white blood cell growth factors or chemotherapy dosing based on muscle value Background This study aim ed to determine the relationship between intra-abdominal infection ( IAI ) and sarcopenia prospect ively and to construct a nomogram to identify patients at a high risk of IAI . Methods We conducted a prospect i ve study of 682 consecutive patients with gastric cancer who underwent radical gastrectomy .  The sarcopenia elements , including lumbar skeletal muscle index , h and grip strength , and gait speed , were measured before surgery . Factors contributing to IAI were determined through univariate and multivariate analysis . A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of IAI . Results Of the 682 patients enrolled in this study , 132 patients were diagnosed with sarcopenia and 61 were diagnosed with IAI . Logistic analysis revealed that sarcopenia , tumor size , pathological type , and multivisceral resection were independent prognostic factors for IAI . The nomogram model for IAI was able to reliably quantify the risk of IAI with a strong optimism-adjusted discrimination ( concordance index , 0.736 ) . Conclusions Sarcopenia is an independent predictor of IAI . Our nomogram was a simple and practical instrument to quantify the individual risk of IAI and could be used to identify patients at a high risk Abstract Background Nutrition screening on admission to hospital is m and ated in many countries , but to date , there is no consensus on which tool is optimal in the oncology setting . Wasting conditions such as cancer cachexia ( CC ) and sarcopenia are common in cancer patients and negatively impact on outcomes ; however , they are often masked by excessive adiposity . This study aim ed to inform the application of screening in cancer population s by investigating whether commonly used nutritional screening tools are adequately capturing nutritionally vulnerable patients , including those with abnormal body composition phenotypes ( CC , sarcopenia , and myosteatosis ) . Methods A prospect i ve study of ambulatory oncology out patients presenting for chemotherapy was performed . A detailed survey incorporating clinical , nutritional , biochemical , and quality of life data was administered . Participants were screened for malnutrition using the Malnutrition Universal Screening Tool ( MUST ) , Malnutrition Screening Tool ( MST ) , and the Nutritional Risk Index ( NRI ) . Computed tomography ( CT ) assessment of body composition was performed to diagnose CC , sarcopenia , and myosteatosis according to consensus criteria . Results A total of 725 patients ( 60 % male , median age 64 years ) with solid tumours participated ( 45 % metastatic disease ) . The majority were overweight/obese ( 57 % ) . However , 67 % were losing weight , and CT analysis revealed CC in 42 % , sarcopenia in 41 % , and myosteatosis in 46 % . Among patients with CT‐identified CC , the MUST , MST , and NRI tools categorized 27 % , 35 % , and 7 % of them as ‘ low nutritional risk ’ , respectively . The percentage of patients with CT‐identified sarcopenia and myosteatosis that were categorised as ‘ low nutritional risk ’ by MUST , MST and NRI were 55 % , 61 % , and 14 % and 52 % , 50 % , and 11 % , respectively . Among these tools , the NRI was most sensitive , with scores < 97.5 detecting 85.8 % , 88.6 % , and 92.9 % of sarcopenia , myosteatosis , and CC cases , respectively . Using multivariate Cox proportional hazards models , NRI score < 97.5 predicted greater mortality risk ( hazard ratio 1.8 , confidence interval : 1.2–2.8 , P = 0.007 ) . Conclusions High numbers of nutritionally vulnerable patients , with demonstrated abnormal body composition phenotypes on CT analysis , were misclassified by MUST and MST . Caution should be exercised when categorizing the nutritional risk of oncology patients using these tools . NRI detected the majority of abnormal body composition phenotypes and independently predicted survival . Of the tools examined , the NRI yielded the most valuable information from screening and demonstrated usefulness as an initial nutritional risk grading system in ambulatory oncology patients
Conclusion The prevalence of sarcopenia depends mostly on the diagnostic cut-off points of different criteria .
Preoperative sarcopenia is a risk factor for both long-term and short-term outcomes
Background The impact of sarcopenia on the outcome of gastrointestinal ( GI ) oncological patients is still controversial .
We aim to discuss the prevalence of sarcopenia and its relation to the oncological outcome .