ArticleJournal of cachexia, sarcopenia and muscle2026
Associations of CT-Derived Skeletal Muscle Index and Density With Postoperative Outcomes Following Colorectal Cancer Surgery.
Article in Journal of cachexia, sarcopenia and muscle, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreoperative skeletal muscle index (SMI) and skeletal muscle density (SMD) are gaining attention as predictors of postoperative outcomes following colorectal cancer (CRC) surgery. We examined the associations between computed tomography (CT)-based SMI and SMD with postoperative outcomes following CRC resection.
methodsThis was a retrospective cohort study of patients who were surgically treated for CRC at a regional hospital in Baton Rouge, Louisiana, United States, from October 2018 to February 2024. CT-based SMI (cm
resultsA total of 415 patients (mean age 63.7, SD 13.2) were included in the analysis, of whom 189 (45.5%) were females. The median LOS was 4 days, while 50 (12.0%) of patients experienced at least one severe postoperative complication. A total of 30 (7.2%) patients were discharged to a non-home location, while 12 (2.9%) patients died within 90 days. Over a median follow-up of 31.6 months, 75 (18.1%) patients died. In multivariable analyses, each 5-unit decrease in SMD was associated with increased LOS (incidence rate ratio [IRR] 1.06, 95%CI 1.02-1.10, p = 0.003), greater odds of severe postoperative complications (odds ratio [OR] 1.25, 95%CI 1.02-1.53, p = 0.029) and non-home discharge (OR 1.40, 95%CI 1.09-1.79, p = 0.007), as well as a higher risk of OM (hazard ratio [HR] 1.26, 95%CI 1.09-1.46, p = 0.002). In unadjusted analysis, each 5-unit decrease in SMD was significantly associated with 90-day mortality (HR 1.36, 95%CI 1.04-1.78, p = 0.024). Low SMD based on two different definitions predicted LOS (IRR 1.21, 95%CI 1.05-1.41, p = 0.010; IRR 1.28, 95%CI 1.11-1.48. p < 0.001), while only one definition was significantly associated with a higher risk of OM (HR 1.93, 95%CI 1.08-3.43, p = 0.027). SMI as a continuous or binary predictor was not significantly associated with postoperative outcomes.
conclusionsCT-based SMD rather than SMI appears to be a more relevant predictor of postoperative outcomes following CRC surgery. Future research should explore whether prehabilitation can improve SMD prior to CRC surgery.
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