ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2025
Physical fitness and body composition assessments in advanced cancer patients undergoing exenterative surgery - A pilot cohort study.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Observational
- Physical fitness and body composition assessments in advanced cancer patients undergoing exenterative surgery - A pilot cohort study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
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16 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aimLocally advanced pelvic malignancies, such as colorectal and anal cancers, can only be cured through multimodal cancer treatment including multi-visceral exenterative resections, which carry a high mortality and morbidity risk. Despite strong predictive abilities in other cancer cohorts, the combined prognostic value of body composition and cardiopulmonary exercise testing (CPET) for major in-hospital morbidity in patients undergoing exenterative surgery for advanced pelvic cancers has not been evaluated.
methodA locally advanced colorectal and anal cancer cohort was derived from a prospectively maintained quaternary database. CPET was undertaken preoperatively, according to national guidelines. Skeletal muscle index (SMI) and radiation attenuation (SM-RA) were obtained from analysing L3 slices from preoperative computed tomography scans using SliceOmatic 5.0 and classified using predefined thresholds. Major morbidity was defined as Clavien-Dindo classification 3a or greater.
resultsFrom 247 patients (58% male, median age 60 years), 62.4% and 35.5% had locally advanced or recurrent disease respectively. Physical fitness variables were significantly reduced in low SMI or low SM-RA patients. In multivariate linear regression, SMI was strongly predictive of oxygen uptake at the anaerobic threshold (B = 0.013, p = 0.001) and at peak (B = 0.015, p = 0.002). 17.3% of all patients experienced a major postoperative complication. In multivariate analysis, reduced peak power output (<1.5 W kg
conclusionCPET may be predictive of in-hospital major morbidity in this cohort. The association of CPET with body composition necessitates further evaluation and external validation in a larger patient cohort, specifically interrogating their combined role in morbidity prediction and as a target for prehabilitation interventions.
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